A retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea-based chemotherapy

Journal of Translational Medicine

Silvia Scoccianti²  Tania Perrone¹  Erminio Bonizzoni⁴  Matteo Santoni⁶  Giuseppina Savio⁵  Franco Perrone³  Beatrice Detti²  Giovanni Silvano⁷  Maria Grazia Fabrini³  Ivan Lolli⁸  Alessandro Paccapelo⁶ 

[1] Italfarmaco Sp.A., Cinisello Balsamo, (MI), Italy;Azienda Ospedaliera Universitaria Careggi, Florence, Italy;Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy;University of Milan, Milan, Italy;Ospedale Civico ARNAS, Palermo, Italy;Department of Medical Oncology, Azienda Ospedaliero-Universitaria, Ospedali Riuniti Umberto I-GM Lancisi and G Salesi, Ancona, Italy;SS. Annunziata Taranto Hospital, Taranto, Italy;Oncologia Medica, IRCCS “Saverio de Bellis”, 70013 via Turi 27, Castellana Grotte, (Ba), Italy

关键词: Temozolomide;    Stupp-regimen;    Recurrent-glioblastoma;    Nitrosourea;    Fotemustine;   

Others  :  1205991
DOI  :  10.1186/1479-5876-10-90

 received in 2012-03-13, accepted in 2012-05-14,  发布年份 2012

【 摘 要 】

Background

At recurrence the use of nitrosoureas is widely-used as a therapeutic option for glioblastoma (GBM) patients. The efficacy of fotemustine (FTM) has been demonstrated in phase II clinical trials; however, these papers report a wide range of progression-free-survival (PFS-6 m) rates, ranging from 21% to 52%. We investigated whether FTM could have a different response pattern in respect to time to adjuvant temozolomide failure, or whether specific independent risk factors could be responsible for the wide range of response rates observed.

Methods

Recurrent GBM patients have been treated with fotemustine 75-100 mg/sqm at day 1, 8, 15 and after 4/5 weeks of rest with 100 mg/sqm every 21 days. Patients were stratified in 4 groups according to time to temozolomide failure: before starting (B0), during the first 6 months (B1), after more than 6 months of therapy (B2), and after a treatment-free interval (B3). Primary endpoint was PFS-6 m. A multivariable analysis was performed to identify whether gender, time after radiotherapy, second surgery and number of TMZ cycles could be independent predictors of the clinical benefit to FTM treatment.

Results

163 recurrent GBM patients were included in the analysis. PFS-6 m rates for the B0, B1, B2 and B3 groups were 25%, 28%, 31.1% and 43.8%, respectively. The probability of disease control was higher in patients with a longer time after radiotherapy (p = 0.0161) and in those who had undergone a second surgery (p = 0.0306).

Conclusions

FTM is confirmed as a valuable therapeutic option for patients with recurrent GBM and was active in all study patient groups. Time after the completion of radiotherapy and second surgery are independent treatment-related risk factors that were predictive of clinical benefit.

【 授权许可】

   
2012 Paccapelo et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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