Glioblastoma Multiforme Clinical Trial
Official title:
Multicenter Phase II Study of Border Zone Stereotactic Radiosurgery With Bevacizumab in Patients With Recurrent or Progressive Glioblastoma Multiforme
This is a phase II study on the usage of stereotactic Gamma Knife radiosurgery as a boost to the tumor bed border zone in conjunction with the usage of bevacizumab.
Glioblastoma Multiforme (GBM) is the most common primary brain tumor in adults.
Unfortunately, despite aggressive surgery, radiation therapy (RT) and chemotherapy, the
prognosis for this disease is poor. It is our hypothesis that GBM is a "local" disease
wherein treatment failure is due to failure to eradicate tumor cells in the pathways along
which the tumor eventually spreads (the "border zone").
The investigators hypothesize that treatment volume escalation will be successful at
improving overall survival in patients with GBM when appropriate targeting and precision dose
delivery is performed in a single treatment session. The 'border zone' of the tumor will be
targeted for SRS (defined as a combination of the MRI volume of gadolinium enhancement plus
up to 2 cm of the surrounding T2 volume). This represents the volume of tumor infiltrated
white matter and is the route of GBM spread. Bevacizumab, a monoclonal antibody to vascular
endothelial growth factor (VEGF), has been used with safety and clinical success with
concomitant chemotherapy in solid tumors, including GBM.
The investigators further hypothesize that a combined approach of SRS with this VEGF
inhibitor will be an effective strategy for GBM because bevacizumab will maximize the effects
of radiation in the treated volume and potentially reduce radiation toxicity in the adjacent
brain.
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