Bevacizumab is registered in the U.S. for the treatment of recurrent glioblastoma based on improved PFS in uncontrolled phase II trials; Recently, a randomized controlled phase II trial studied lomustin, bevacizumab or the combination of both compounds in the treatment of glioblastoma at first recurrence (BELOB trial). While showing some promise for the combination, there was no signal observed that single agent therapy with bevacizumab would be superior to lomustin, in terms of progression free survival and overall survival. In Belgium, bevacizumab has been temporarily made available for the treatment of glioblastoma in a medical need program (MNP) between 2011 and 2013. We made a retrospective study in a single institution, comparing a cohort of patients that was treated with bevacizumab at first recurrence during the MNP, with a cohort of patients that was treated with lomustin at first recurrence in a similar time period preceding the MNP. Bevacizumab was administered biweekly at a dose of 10 mg/kg. Lomustine was prescribed at a dose of 110 mg/msq evey six weeks. Routine tumor evaluation was similar and involved MR imaging at baseline, at 6 and 12 weeks, and every 12 weeks thereafter. The outcome parameters were progression free survival at six months (PFS-6) using RANO criteria, and overall survival at 9 months (OS-9). We identified 48 patients of whom 23 were treated with lomustin and 25 with bevacizumab. PFS-6 and OS-9 were 26% and 30% for lomustin and 24% and 36% for bevacizumab, respectively. Median PFS and median OS were 3 and 6 months for lomustin and 4 and 7 months for bevacizumab, respectively. Although our study is of retrospective nature, the temporary availability of bevacizumab during two years for this indication has created a bevacizumab-treated cohort of patients that could be compared to a similar cohort treated with lomustin. Because a standardized follow-up schedule with MR imaging is used at our institution, the bias in terms of tumor evaluation is acceptable, although the patients treated with bevacizumab visited more frequently as a result of the biweekly administration. Our data are in line with the observations made in the BELOB trial and do not support the common idea that bevacizumab would be significantly superior to lomustin, when used as a single agent in this setting.