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Fotemustine: A Third-Generation Nitrosourea for the Treatment of Recurrent Malignant Gliomas

Malignant gliomas account for approximately 60% of all primary brain tumors in adults. The prognosis for patients with malignant glioma has not changed significantly in recent years. Despite debulking surgery, radiotherapy and cytotoxic chemotherapy, the median survival time is nine to 12 months, an...

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Detalles Bibliográficos
Autor principal: Beauchesne, Patrick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712672/
https://www.ncbi.nlm.nih.gov/pubmed/24213227
http://dx.doi.org/10.3390/cancers4010077
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author Beauchesne, Patrick
author_facet Beauchesne, Patrick
author_sort Beauchesne, Patrick
collection PubMed
description Malignant gliomas account for approximately 60% of all primary brain tumors in adults. The prognosis for patients with malignant glioma has not changed significantly in recent years. Despite debulking surgery, radiotherapy and cytotoxic chemotherapy, the median survival time is nine to 12 months, and very few, if any, patients are cured from this illness. Fotemustine is an alkylating agent characterized by the grafting of a phosphonoalanine group onto the nitrosourea radical with consequent high lipophilicity and improved diffusion through the cell membrane and the blood-brain barrier. Fotemustine has been registered for use in two indications: disseminated malignant melanoma, including cerebral metastases, and primary brain tumors. Fotemustine is currently used in Europe, particularly in France and Italy, as a salvage therapy for recurrent malignant gliomas. Myelosuppression, leucopenia and thrombocytopenia are the most frequent side effects of treatment with fotemustine. The objective response to this treatment is between 26% and 70%, and the reported median survival time is 10 months. New drug combinations containing fotemustine and angiogenesis inhibitors, such as bevacizumab, are currently under development. In this review, we describe all the combinations of fotemustine currently used in clinical practice for recurrent malignant gliomas.
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spelling pubmed-37126722013-08-05 Fotemustine: A Third-Generation Nitrosourea for the Treatment of Recurrent Malignant Gliomas Beauchesne, Patrick Cancers (Basel) Review Malignant gliomas account for approximately 60% of all primary brain tumors in adults. The prognosis for patients with malignant glioma has not changed significantly in recent years. Despite debulking surgery, radiotherapy and cytotoxic chemotherapy, the median survival time is nine to 12 months, and very few, if any, patients are cured from this illness. Fotemustine is an alkylating agent characterized by the grafting of a phosphonoalanine group onto the nitrosourea radical with consequent high lipophilicity and improved diffusion through the cell membrane and the blood-brain barrier. Fotemustine has been registered for use in two indications: disseminated malignant melanoma, including cerebral metastases, and primary brain tumors. Fotemustine is currently used in Europe, particularly in France and Italy, as a salvage therapy for recurrent malignant gliomas. Myelosuppression, leucopenia and thrombocytopenia are the most frequent side effects of treatment with fotemustine. The objective response to this treatment is between 26% and 70%, and the reported median survival time is 10 months. New drug combinations containing fotemustine and angiogenesis inhibitors, such as bevacizumab, are currently under development. In this review, we describe all the combinations of fotemustine currently used in clinical practice for recurrent malignant gliomas. MDPI 2012-02-01 /pmc/articles/PMC3712672/ /pubmed/24213227 http://dx.doi.org/10.3390/cancers4010077 Text en © 2012 by the authors; licensee MDPI, Basel, Switzerland. http://creativecommons.org/licenses/by/3.0/ This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license (http://creativecommons.org/licenses/by/3.0/).
spellingShingle Review
Beauchesne, Patrick
Fotemustine: A Third-Generation Nitrosourea for the Treatment of Recurrent Malignant Gliomas
title Fotemustine: A Third-Generation Nitrosourea for the Treatment of Recurrent Malignant Gliomas
title_full Fotemustine: A Third-Generation Nitrosourea for the Treatment of Recurrent Malignant Gliomas
title_fullStr Fotemustine: A Third-Generation Nitrosourea for the Treatment of Recurrent Malignant Gliomas
title_full_unstemmed Fotemustine: A Third-Generation Nitrosourea for the Treatment of Recurrent Malignant Gliomas
title_short Fotemustine: A Third-Generation Nitrosourea for the Treatment of Recurrent Malignant Gliomas
title_sort fotemustine: a third-generation nitrosourea for the treatment of recurrent malignant gliomas
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3712672/
https://www.ncbi.nlm.nih.gov/pubmed/24213227
http://dx.doi.org/10.3390/cancers4010077
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