The authors present an important multicenter retrospective analysis – the largest Canadian cohort to date – characterizing bevacizumab use and outcomes in recurrent glioblastoma (rGBM). Their findings on survival improvement when bevacizumab is initiated within 6 months of radiation, quality of life metrics and practice patterns by center volume contribute robustly to neuro-oncology discourse. ^{Reference Kim, Umemura and Leung1}

A notable strength is the detailed reporting of corticosteroid reduction and maintenance of performance status, pivotal for patient well-being. The association between higher-volume centers and improved survival opens avenues for future system-level inquiry. ^{Reference Kim, Umemura and Leung1,Reference Taal, Oosterkamp and Walenkamp2} Limitations, such as evolving biomarker reporting and incomplete molecular datasets, are transparently addressed and provide context for future research. ^{Reference Wick, Gorlia and Bendszus3,Reference Louis, Perry and Wesseling4,Reference Stupp, Mason and van den Bent5}

The discussion rightly emphasizes the heterogeneity of treatment approaches, the need for expert radiology to distinguish pseudoprogression and the non-causal association of added chemotherapy – all while avoiding overinterpretation.

This work is a substantial addition to both Canadian and international understanding of rGBM management. The authors deserve commendation for methodological rigor and thoughtful, balanced interpretation.