Aykut ÖZMEN, Gökmen Umut ERDEM
Journal of Oncological Sciences - 2026;12(2):262-268
Objective: High-grade gliomas (HGGs), particularly glioblastoma, remain among the most aggressive primary central nervous system malignancies. Despite standard treatment consisting of maximal safe resection followed by radiotherapy with concurrent and adjuvant temozolomide, disease recurrence is nearly inevitable. Therapeutic options after progression remain limited, and the optimal management of recurrent HGGs continues to be debated. This study aimed to evaluate the real-world efficacy of second-line irinotecan plus bevacizumab in patients with recurrent HGGs. Material and Methods: This retrospective single-center study included patients with recurrent HGGs treated at University of Health Sciences Türkiye, Başakşehir Çam and Sakura City Hospital between January 2020 and December 2024. Demographic, clinical, pathological, treatment, and survival data were collected from institutional medical records. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Objective response rates (ORRs) were assessed according to radiological evaluations documented in routine clinical practice. Results: A total of 55 patients were included. The median age was 50 years, and 76% of patients had glioblastoma. Following first-line chemoradiotherapy, 48 patients received adjuvant temozolomide, with a median PFS of 5.0 months. Fifty patients subsequently received second-line irinotecan plus bevacizumab, achieving an ORR of 46%. The median PFS associated with irinotecan plus bevacizumab was 8.8 months. At the final analysis, the median OS for the entire cohort was 23.4 months. Conclusion: Second-line irinotecan plus bevacizumab demonstrated meaningful clinical activity in recurrent HGGs, yielding encouraging response rates and disease control in a real-world setting. These findings support the continued use of bevacizumab-based strategies for selected patients with recurrent disease.
