A retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea-based chemotherapy
<p>Abstract</p> <p>Background</p> <p>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 ra...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2012-05-01
|
| Series: | Journal of Translational Medicine |
| Subjects: | |
| Online Access: | http://www.translational-medicine.com/content/10/1/90 |
| _version_ | 1811284683943575552 |
|---|---|
| author | Paccapelo Alessandro Lolli Ivan Fabrini Maria Silvano Giovanni Detti Beatrice Perrone Franco Savio Giuseppina Santoni Matteo Bonizzoni Erminio Perrone Tania Scoccianti Silvia |
| author_facet | Paccapelo Alessandro Lolli Ivan Fabrini Maria Silvano Giovanni Detti Beatrice Perrone Franco Savio Giuseppina Santoni Matteo Bonizzoni Erminio Perrone Tania Scoccianti Silvia |
| author_sort | Paccapelo Alessandro |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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).</p> <p>Conclusions</p> <p>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.</p> |
| first_indexed | 2024-04-13T02:33:08Z |
| format | Article |
| id | doaj.art-bfd2341d11bd46cebb970d61ec5ce064 |
| institution | Directory Open Access Journal |
| issn | 1479-5876 |
| language | English |
| last_indexed | 2024-04-13T02:33:08Z |
| publishDate | 2012-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Translational Medicine |
| spelling | doaj.art-bfd2341d11bd46cebb970d61ec5ce0642022-12-22T03:06:30ZengBMCJournal of Translational Medicine1479-58762012-05-011019010.1186/1479-5876-10-90A retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea-based chemotherapyPaccapelo AlessandroLolli IvanFabrini MariaSilvano GiovanniDetti BeatricePerrone FrancoSavio GiuseppinaSantoni MatteoBonizzoni ErminioPerrone TaniaScoccianti Silvia<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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).</p> <p>Conclusions</p> <p>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.</p>http://www.translational-medicine.com/content/10/1/90FotemustineNitrosoureaRecurrent-glioblastomaStupp-regimenTemozolomide |
| spellingShingle | Paccapelo Alessandro Lolli Ivan Fabrini Maria Silvano Giovanni Detti Beatrice Perrone Franco Savio Giuseppina Santoni Matteo Bonizzoni Erminio Perrone Tania Scoccianti Silvia A retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea-based chemotherapy Journal of Translational Medicine Fotemustine Nitrosourea Recurrent-glioblastoma Stupp-regimen Temozolomide |
| title | A retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea-based chemotherapy |
| title_full | A retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea-based chemotherapy |
| title_fullStr | A retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea-based chemotherapy |
| title_full_unstemmed | A retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea-based chemotherapy |
| title_short | A retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea-based chemotherapy |
| title_sort | retrospective pooled analysis of response patterns and risk factors in recurrent malignant glioma patients receiving a nitrosourea based chemotherapy |
| topic | Fotemustine Nitrosourea Recurrent-glioblastoma Stupp-regimen Temozolomide |
| url | http://www.translational-medicine.com/content/10/1/90 |
| work_keys_str_mv | AT paccapeloalessandro aretrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT lolliivan aretrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT fabrinimaria aretrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT silvanogiovanni aretrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT dettibeatrice aretrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT perronefranco aretrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT saviogiuseppina aretrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT santonimatteo aretrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT bonizzonierminio aretrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT perronetania aretrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT scocciantisilvia aretrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT paccapeloalessandro retrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT lolliivan retrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT fabrinimaria retrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT silvanogiovanni retrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT dettibeatrice retrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT perronefranco retrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT saviogiuseppina retrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT santonimatteo retrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT bonizzonierminio retrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT perronetania retrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy AT scocciantisilvia retrospectivepooledanalysisofresponsepatternsandriskfactorsinrecurrentmalignantgliomapatientsreceivinganitrosoureabasedchemotherapy |