Temodar and Avastin for glioblastoma – pro

Glioblastoma is a disease for which there were few options available until recently. The past several years brought several new potentially promising treatments and one, Temodar as a single drug, has been FDA approved for this indication. Irinotecan and Avastin is a promising new combination for gliolastoma, which NCCN now recommends. However, Avastin with Temodar is not as well explored and is not NCCN recommended. I was able to find one preliminary report of this combination. It is still in clinical trials. For example, there is a phase II study: Bevacizumab in Combination With Metronomic Temozolomide for Recurrent Malignant Glioma, NCT00501891, in Duke( completed but not published). There is also a phase II trial of the two in combination with radiation.

However, recently another phase II trial was reported, albeit with radiation. Another approach is with metronomic Temodar dosing.

Desjardins et al It found that  regimen of combined daily temozolomide and biweekly bevacizumab had some activity and was well tolerated. However, the results obtained in this study were inferior to those observed in studies of bevacizumab monotherapy and of combined irinotecan and bevacizumab therapy. The population was more heterogeneous and was pretreated more heavily than patients in previous studies. Clearly more investigation is needed before Temodar combintions can be used routinely.

Desjardins A, Reardon DA, Coan A, Marcello J, Herndon JE 2nd, Bailey L, Peters KB, Friedman HS, Vredenburgh JJ.Bevacizumab and daily temozolomide for recurrent glioblastoma.Cancer. 2011 Jul 26.

nccn.org, brain cancer, p. 38

A. Reardon, Patrick Y. Wen Therapeutic Advances in the Treatment of Glioblastoma: Rationale and Potential Role of Targeted Agents The Oncologist, Vol. 11, No. 2, 152-164, February 2006

Stark-Vance V. Bevacizumab and CPT-11 in the treatment of relapsed malignant glioma. Neurooncol 2005;7:369.


Maron, R., Vredenburgh, J. J., Desjardins, A., Reardon, D. A., Quinn, J. A., Rich, J. N., Gururangan, S., Wagner, S. A., Salacz, M. E., Friedman, H. S. Bevacizumab and daily temozolomide for recurrent glioblastoma multiforme (GBM) J Clin Oncol (Meeting Abstracts) 2008 26: 2074

A. Lai, P. Nghiemphu, R. Green, L. Spier, S. Peak, S. Phuphanich, L. Fehrenbacher, T. Kolevska, J. Polikoff, T. Cloughesy; Phase II trial of bevacizumab in combination with temozolomide and regional radiation therapy for up-front treatment of patients with newly diagnosed glioblastoma multiforme, CA J Clin Oncol 27:15s, 2009 (suppl; abstr 2000)

Gruber, M. L., Raza, S., Gruber, D., Narayana, A.
Bevacizumab in combination with radiotherapy plus concomitant and adjuvant temozolomide for newly diagnosed glioblastoma: Update progression-free survival, overall survival, and toxicity J Clin Oncol (Meeting Abstracts) 2009 27: 2017


Participate in our Forums

To ask questions or participate in a discussion, please visit our Forums. You must LOGIN to participate.

Help Us Help Others

You can become a Site Sponsor. Or you may wish to support our work with a Donation.

Focused Articles For You

Lay Portal