TAVAwRECk.

Just when you thought cetuximab was having a bad week, bevacizumab comes in like a wrecking ball. The phase 2 TAVAREC trial trial looked for activity of bevacizumab in addition to temozolomide in recurrent WHO II-III gliomas. More specifically, patients had to have had 1p19q intact tumors with enhancing components. Due to the known “pseudoresponse” effect with bevacizumab in enhancing gliomas, overall survival (OS) and not progression-free survival (PFS) was used as the primary endpoint. The population included roughly 50/50 grade II/III original tumors with 65% having IDH mutations. The majority (>90%) had received prior radiation, but only about 25% received prior chemotherapy. The addition of bevacizumab to temozolomide sadly didn’t improve any outcome, and there were plenty: OS, PFS, quality of life, neurocognitive function. What was heartening? Neither the manuscript nor the editorial hide their disgust with TAVAREC’s outcomes. TBL: “The findings of this study provide no support for further phase 3 studies on the role of bevacizumab in this disease.” Ouch. | van den Bent, Lancet Oncol 2018