Extended-schedule dose-dense temozolomide in refractory gliomas
Por:
Berrocal, A, Segura, PP, Gil, M, Balana, C, Lopez, JG, Yaya, R, Rodriguez, J, Reynes, G, Gallego, O, Iglesias, L
Publicada:
1 feb 2010
Resumen:
This multicenter phase II study conducted by the Spanish Neuro-Oncology Group evaluated the activity of an extended, dose-dense temozolomide regimen in patients with temozolomide-refractory malignant glioma. Adult patients (at least 18 years of age) with WHO grade III or IV glioma and a Karnofsky Performance Status of 60 or higher were treated with temozolomide (85 mg/m(2)/day) for 21 consecutive days every 28-day cycle until disease progression or unacceptable toxicity. All patients had developed progressive disease either during or less than 3 months after completing previous temozolomide treatment. Forty-seven patients were treated with a median of 2 (range, 1-13) cycles of temozolomide. Before study entry, patients had received a median of 6 cycles of temozolomide: 39 (83%) as part of initial therapy and 23 (49%) as second-line therapy. Three patients (6.4%) had a partial response with durations of 8.0, 3.5, and 3.2 months; 15 patients (31.9%) had stable disease with a median duration of 2.1 months, including 2 patients with stable disease (SD) for greater than 6 months (14 and 16 months). Median time to progression was 2 months, and median overall survival from study entry was 5.1 months. The 6-month progression-free survival rate was 16.7%. The most common hematologic toxicities were lymphopenia, thrombocytopenia, and leukopenia. Lymphopenia occurred in 83% of patients and was grade 3 in 28%, but no opportunistic infections occurred. In conclusion, this extended dose-dense schedule of temozolomide appears to have modest activity in patients refractory to previous treatment with temozolomide and is associated with manageable toxicity.
Filiaciones:
Berrocal, A:
Consorcio Hosp Gen Univ Valencia, Med Oncol Serv, Valencia 46006, Spain
Segura, PP:
Hosp Clin San Carlos, Madrid, Spain
Gil, M:
Inst Catalan Oncol Duran & Reynals, Barcelona, Spain
Balana, C:
Hosp Badalona Germans Trias & Pujol, Badalona, Spain
Lopez, JG:
Hosp Ramon & Cajal, E-28034 Madrid, Spain
Yaya, R:
Inst Valenciano Oncol, Valencia, Spain
Rodriguez, J:
Hosp Sondureta, Palma de Mallorca, Spain
Reynes, G:
Hosp La Fe, E-46009 Valencia, Spain
Gallego, O:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Iglesias, L:
Hosp Virgen del Rocio, Seville, Spain
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