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Non-conventional fotemustine schedule as second-line treatment in recurrent malignant gliomas: Survival across disease and treatment subgroup analysis and review of the literature

Fotemustine (FTM) is a treatment option in recurrent malignant gliomas (MGs) after first-line Stupp treatment. The efficacy and the safety of fractionated FTM schedule proposed by Addeo et al was analysed in the present study in recurrent MGs patients. A retrospective analysis on 40 recurrent MGs pa...

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Autores principales: Prelaj, Arsela, Rebuzzi, Sara Elena, Grassi, Massimiliano, Salvati, Maurizio, D'Elia, Alessandro, Buttarelli, Francesca, Ferrara, Carla, Tomao, Silverio, Bianco, Vincenzo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: D.A. Spandidos 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313958/
https://www.ncbi.nlm.nih.gov/pubmed/30655978
http://dx.doi.org/10.3892/mco.2018.1746
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author Prelaj, Arsela
Rebuzzi, Sara Elena
Grassi, Massimiliano
Salvati, Maurizio
D'Elia, Alessandro
Buttarelli, Francesca
Ferrara, Carla
Tomao, Silverio
Bianco, Vincenzo
author_facet Prelaj, Arsela
Rebuzzi, Sara Elena
Grassi, Massimiliano
Salvati, Maurizio
D'Elia, Alessandro
Buttarelli, Francesca
Ferrara, Carla
Tomao, Silverio
Bianco, Vincenzo
author_sort Prelaj, Arsela
collection PubMed
description Fotemustine (FTM) is a treatment option in recurrent malignant gliomas (MGs) after first-line Stupp treatment. The efficacy and the safety of fractionated FTM schedule proposed by Addeo et al was analysed in the present study in recurrent MGs patients. A retrospective analysis on 40 recurrent MGs patients and second-line fractionated FTM chemotherapy was performed. Response evaluation was assessed using RANO criteria and safety was assessed using CTCAE v.4.03. Subgroup analyses based on MGMT methylation, resurgery and reirradiation were performed. A review of the literature was also performed. The results revealed 5 partial responses (13%) and 19 stable diseases (47%) with a disease-control rate of 60%. Median progression-free survival (PFS) was 4 months, with a PFS of 33% at 6 months and 13% at 1 year. The median overall survival (OS) was 9 months and OS at 6 months was of 55% and at 1 year of 30%. Methylated patients experienced longer mPFS (6 vs. 3 months; p=0.004) and mOS (10 vs. 4 months; p<0.0001) compared with unmethylated patients. Patients treated with reirradiation experienced longer mPFS (5 vs. 3.5 months; p=0.48) and mOS (10 vs. 5 months; p=0.11). No survival benefit with resurgery was observed. Furthermore, the fractioned schedule was well tolerated, only 15% of patients developed severe myelotoxicities. Considering the present findings, fractionated FTM schedule is an efficient second-line option for MGs associated with an acceptable myelotoxicity profile. Additionally, MGMT methylation is associated with improved survival outcomes. However, this study highlights the requirement for further prospective randomized studies on resurgery and reirradiation.
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spelling pubmed-63139582019-01-17 Non-conventional fotemustine schedule as second-line treatment in recurrent malignant gliomas: Survival across disease and treatment subgroup analysis and review of the literature Prelaj, Arsela Rebuzzi, Sara Elena Grassi, Massimiliano Salvati, Maurizio D'Elia, Alessandro Buttarelli, Francesca Ferrara, Carla Tomao, Silverio Bianco, Vincenzo Mol Clin Oncol Articles Fotemustine (FTM) is a treatment option in recurrent malignant gliomas (MGs) after first-line Stupp treatment. The efficacy and the safety of fractionated FTM schedule proposed by Addeo et al was analysed in the present study in recurrent MGs patients. A retrospective analysis on 40 recurrent MGs patients and second-line fractionated FTM chemotherapy was performed. Response evaluation was assessed using RANO criteria and safety was assessed using CTCAE v.4.03. Subgroup analyses based on MGMT methylation, resurgery and reirradiation were performed. A review of the literature was also performed. The results revealed 5 partial responses (13%) and 19 stable diseases (47%) with a disease-control rate of 60%. Median progression-free survival (PFS) was 4 months, with a PFS of 33% at 6 months and 13% at 1 year. The median overall survival (OS) was 9 months and OS at 6 months was of 55% and at 1 year of 30%. Methylated patients experienced longer mPFS (6 vs. 3 months; p=0.004) and mOS (10 vs. 4 months; p<0.0001) compared with unmethylated patients. Patients treated with reirradiation experienced longer mPFS (5 vs. 3.5 months; p=0.48) and mOS (10 vs. 5 months; p=0.11). No survival benefit with resurgery was observed. Furthermore, the fractioned schedule was well tolerated, only 15% of patients developed severe myelotoxicities. Considering the present findings, fractionated FTM schedule is an efficient second-line option for MGs associated with an acceptable myelotoxicity profile. Additionally, MGMT methylation is associated with improved survival outcomes. However, this study highlights the requirement for further prospective randomized studies on resurgery and reirradiation. D.A. Spandidos 2019-01 2018-10-16 /pmc/articles/PMC6313958/ /pubmed/30655978 http://dx.doi.org/10.3892/mco.2018.1746 Text en Copyright: © Prelaj et al. This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
spellingShingle Articles
Prelaj, Arsela
Rebuzzi, Sara Elena
Grassi, Massimiliano
Salvati, Maurizio
D'Elia, Alessandro
Buttarelli, Francesca
Ferrara, Carla
Tomao, Silverio
Bianco, Vincenzo
Non-conventional fotemustine schedule as second-line treatment in recurrent malignant gliomas: Survival across disease and treatment subgroup analysis and review of the literature
title Non-conventional fotemustine schedule as second-line treatment in recurrent malignant gliomas: Survival across disease and treatment subgroup analysis and review of the literature
title_full Non-conventional fotemustine schedule as second-line treatment in recurrent malignant gliomas: Survival across disease and treatment subgroup analysis and review of the literature
title_fullStr Non-conventional fotemustine schedule as second-line treatment in recurrent malignant gliomas: Survival across disease and treatment subgroup analysis and review of the literature
title_full_unstemmed Non-conventional fotemustine schedule as second-line treatment in recurrent malignant gliomas: Survival across disease and treatment subgroup analysis and review of the literature
title_short Non-conventional fotemustine schedule as second-line treatment in recurrent malignant gliomas: Survival across disease and treatment subgroup analysis and review of the literature
title_sort non-conventional fotemustine schedule as second-line treatment in recurrent malignant gliomas: survival across disease and treatment subgroup analysis and review of the literature
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6313958/
https://www.ncbi.nlm.nih.gov/pubmed/30655978
http://dx.doi.org/10.3892/mco.2018.1746
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