Brain cancer: Cognition and quality of life important factors

In a large national, cooperative trial led by MD Anderson, researchers determined bevacizumab (Avastin), did not offer survival benefit to patients with newly-diagnosed glioblastoma.

The most common and deadly form of brain tumors, glioblastoma afflicts more than 22,000 people each year. Bevacizumab is currently approved in second-line treatment for patients with recurrent disease.

As a complement to the survival study, two related MD Anderson studies are shedding light on the quality of life and cognitive function of brain cancer patients receiving bevacizumab in the front-line setting.

Jeffrey Wefel, Ph.D., associate professor in MD Anderson's Department of Neuro-Oncology, says it's hypothesized that bevacizumab may affect the radiographic characteristics of a brain scan making it difficult to see tumor progression.

As a result, the study sought to determine whether radiographic improvement correlated with improvement in neurocognitive function.

The study enrolled 507 patients over 43 weeks and the results were disappointing. At week 34, patients receiving bevacizumab had a higher level of cognitive decline in information processing speed and executive function, a set of skills involved in tasks such as planning and organizing information than those receiving a placebo.

Wefel said the takeaway for brain cancer patients is to have careful assessment of cognitive function at the time of diagnosis and across treatments to understand how the disease could be impacting the brain.

Additional Declines Seen

Besides cognitive function, Terri Armstrong, Ph.D., adjunct professor in MD Anderson's Department of Neuro-Oncology, found bevacizumab plays a role in patient's quality of life as well.

Looking at patient-reported outcomes, the hope was that as treatment controlled patient's tumors, they would begin to feel better as a result, Armstrong said. However, quality of life measures such as fatigue and symptom burden were also greater among those taking bevacizumab.

"The idea of our research was to put together the total picture of this treatment, not only how it affects the tumor, but how it affects individuals and how they go about their lives," she said.

Additional information

MD Anderson news release

Related studies at ASCO

Test helps identify glioblastoma patients most likely to benefit from bevacizumab