Blood baseline neutrophil count to predict bevacizumab efficacy in glioblastoma.

Authors

null

Aurelie Bertaut

Georges-Francois Leclerc Cancer Center, Dijon, France

Aurelie Bertaut , Romain Boidot , Rachid Madkouri , Coureche guillaume Kaderbhai , Julie Vincent , Bruno Chauffert , Francois Ghiringhelli

Organizations

Georges-Francois Leclerc Cancer Center, Dijon, France, Georges François Leclerc Cancer Center, Dijon, France, CHU Dijon, Dijon, France, Centre GF Leclerc, Dijon, France, University Hospital (CHU) - Department of Medical Oncology, Amiens, France, Centre Georges-François Leclerc, Dijon, France

Research Funding

Other

Background: Bevacizumab is frequently used at recurrence of glioblastoma. However, no biomarker could predict its efficacy. Methods: Exploratory cohort consisted in all patients treated with Stupp regimen for a glioblastoma in Dijon cancer center (N = 265). A validation cohort was TEMAVIR trial which compared 120 patients suffering from glioblastoma treated with Stupp regimen versus bevacizumab plus irinotecan followed by Stupp regimen plus bevacizumab. CSF3 expression was determined in a cohort of 202 patients from the cancer genome atlas. Prognosis role of CSF3expression was next determined in an independent cohort of 23 patients treated with bevacizumab for a recurrent glioblastoma. Results: In the exploratory cohort, bevacizumab increased median overall survival (OS) 18.7 vs 11.3 months, p = 0.0014. Upon multivariate analysis, the age, type of initial surgery, neutrophil count, Karnofsky status > 70%, bevacizumab administration were an independent prognosis factors of survival. We detected an interaction between bevacizumab use and neutrophil count at baseline. Cut off value of neutrophil count was set at 6000/mm3. Only patients with a high level of neutrophil benefited in term of overall survival from the bevacizumab administration (17.3 months (CI95% 14.6-20.4) for patients that received bevacizumab versus vs 8.8 months CI95% 6.4-10.3) for others (p < 0.0001)). Overall survival was not significantly improved for remaining patients treated with bevacizumab with low neutrophil count (21.6 months (CI95% 18.0-23.3) for patients that received bevacizumab versus 15.9 months (CI95%12.0-19.9) for the others (p = 0.7313)).Similar results were obtained in the TEMAVIR trial. Transcriptomic data underlined that expression of CSF3, the gene encoding G-CSF, was correlated with VEGF-A expression. In another independent cohort, we also observed this association between high CSF3expression in tumor and a better survival in patients treated with bevacizumab at recurrence. Conclusions: Only patients with a high level of neutrophil before initiation of bevacizumab treatment benefited from this therapy. Neutrophil count at baseline is a predictive biomarker of efficacy of bevacizumab for glioblastoma bearing patients

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Abstract Details

Meeting

2016 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Citation

J Clin Oncol 34, 2016 (suppl; abstr 2024)

DOI

10.1200/JCO.2016.34.15_suppl.2024

Abstract #

2024

Poster Bd #

213

Abstract Disclosures

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