Glioblastoma Recurrence after Cediranib Therapy in Patients: Lack of “Rebound” Revascularization as Mode of Escape

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RESULTS
Patient characteristics and response to cediranib treatment

All five rGBM patients studied received cediranib (starting dose of 45 mg/kg/day) for at least 2 cycles (range 56–232 days). Cediranib showed some radiographic activity in all of these patients: four showed partial response (P1, P2, P4 and P5) and one a stable disease (P3) based on MRI performed at 28 days (Table 1 and Supplementary Figure S1). At the “end-of-study” MRI scan when compared to day 28 MRI, two patients showed stable disease by imaging but were progressing clinically (P1 and P4), two patients (P2 and P5) showed increased tumor volume by T1 post contrast MRI, and three patients (P1, P2 and P4) showed significantly increased FLAIR signal suggestive of infiltrating disease (Table 1 and Supplementary Figure S1). Four of the five patients received no other treatment after cediranib discontinuation. One patient (P2) received further anti-VEGF treatment with bevacizumab (3 cycles) and CPT-11 (irinotecan, 1 cycle). Examination of the specimen from this patient showed a similar pattern to the other four, thus data from all five patients are presented. The five rGBM patients had a total survival of 161, 259, 175, 186 and 226 days respectively, measured from the time of the first cediranib dose. Of interest, the median overall survival (OS) for the 31 patients enrolled in the phase 2 study was 227 days (177–293 days)(11). Clinicopathological data of control cases are summarized in Tables


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074948/