Addition of lomustine for bevacizumab-refractory recurrent glioblastoma

Tonder, Michaela; Eisele, Günter; Weiss, Tobias; Höfer, Silvia; Seystahl, Katharina; Valavanis, A; Stupp, Roger; Weller, Michael

doi:10.3109/0284186x.2014.920960

Cited by 11 publications

(5 citation statements)

References 18 publications

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“…Even though highly potent cytotoxic drugs are available to oncologists, all efforts for further increase of the median survival of patients suffering from malignant gliomas through the systemic administration of chemotherapeutics have proven to be in vain [Karathanasis and Ghaghada, 2016]. Objective response rates for chemotherapy in GBM do not exceed 11%, and several new therapeutic agents have appeared to not be effective [Batchelor et al, 2013;Tonder et al, 2014;Wen et al, 2014].…”

Section: Introductionmentioning

confidence: 99%

EMP‐induced BBB‐disruption enhances drug delivery to glioma and increases treatment efficacy in rats

Zhang

et al. 2017

Bioelectromagnetics

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Chemotherapy on gliomas is not satisfactorily efficient because the presence of blood-brain barriers (BBB) leads to inadequate exposure of tumor cells to administered drugs. In order to facilitate chemotherapeutics to penetrate BBB and increase the treatment efficacy of gliomas, electromagnetic pulse (EMP) was applied and the 1-(2-Chlorethyl)-cyclohexyl-nitrosourea (CCNU) lomustine concentration in tumor tissue, tumor size, tumor apoptosis, and side effects were measured in glioma-bearing rat model. The results showed that EMP exposure could enhance the delivery of CCNU to tumor tissue, facilitate tumor apoptosis, and inhibit tumor growth without obvious side effects. The data indicated that EMP-induced BBB disruption could enhance delivery of CCNU to glioblastoma multiforme and increase treatment efficacy in glioma-bearing rats. Bioelectromagnetics. 39:60-67, 2018. © 2017 Wiley Periodicals, Inc.

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Section: Introductionmentioning

confidence: 99%

EMP‐induced BBB‐disruption enhances drug delivery to glioma and increases treatment efficacy in rats

Zhang

et al. 2017

Bioelectromagnetics

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“…The antiangiogenic agent bevacizumab has been approved for recurrent glioblastoma in the US but not in most European countries [5]. Other treatment options that are frequently used include reresection [6], the administration of nitrosoureas such as lomustine [7,8,9,10], rechallenge with TMZ [11], and numerous experimental drugs [12]. In general, these treatment options show limited activity.…”

Section: Introductionmentioning

confidence: 99%

Carboplatin and Etoposide in Heavily Pretreated Patients with Progressive High-Grade Glioma

et al. 2014

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Background: Treatment of recurrent anaplastic glioma and glioblastoma remains a particular challenge in neurooncology. The lack of controlled trials results in poor evidence for all therapeutic options. Upon recurrence, many patients are treated with bevacizumab or one of the frequently used nitrosoureas such as lomustine. However, patients who still present in overall good condition after failure of multiple lines of therapy may ask for additional therapy. Methods: Here, we report our experience with the use of carboplatin in combination with etoposide as fourth- or fifth-line therapy in patients with progressive high-grade glioma. Results: The median Karnofsky performance status at the beginning of treatment was 80%. The median progression-free survival (PFS) was 2.5 months. PFS at 6 months was 0%. Administration of carboplatin and etoposide was associated with grade 3 or 4 hematotoxicity in 8 of 12 patients. Conclusion: Carboplatin in combination with etoposide has an unfavorable risk-benefit profile in heavily pretreated glioma patients.

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“…22 Several trials documented the optimal dose and timing of combination treatment using bevacizumab and lomustine. [31][32][33] Bevacizumab 5 mg/kg every 2 weeks in combination with lomustine 90 mg/m 2 had some potential in the regression on tumor vasculature. 34 Combining bevacizumab with lomustine also showed an extension of PFS and overall survival compared with only bevacizumab.…”

Section: Discussionmentioning

confidence: 99%

“…Several trials documented the optimal dose and timing of combination treatment using bevacizumab and lomustine 31–33 . Bevacizumab 5 mg/kg every 2 weeks in combination with lomustine 90 mg/m 2 had some potential in the regression on tumor vasculature 34 .…”

Section: Discussionmentioning

confidence: 99%

The Efficacy and Safety of Adjuvant Lomustine to Chemotherapy for Recurrent Glioblastoma: A Meta-analysis of Randomized Controlled Studies

2022

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IntroductionLomustine is regarded as 1 common anti–vascular endothelial growth factor agent. The efficacy of adjuvant lomustine to chemotherapy remains controversial for recurrent glioblastoma. We conduct this meta-analysis to explore the influence of adjuvant lomustine on treatment efficacy of recurrent glioblastoma.MethodsWe have searched PubMed, EMBASE, Web of Science, EBSCO, and Cochrane library databases through August 2019 and included randomized controlled trials assessing the efficacy and safety of adjuvant lomustine for recurrent glioblastoma.ResultsFour randomized controlled trials are included in the meta-analysis. Overall, compared with the control group for recurrent glioblastoma, adjuvant lomustine has no substantial effect on objective response (risk ratio [RR], 1.32; 95% confidence interval [CI], 0.91 to 1.93; P = 0.15), complete response (RR, 1.76; 95% CI, 0.26–11.90; P = 0.56), progressive response (RR, 1.32; 95% CI, 0.88–1.99; P = 0.18), median progression-free survival (standard mean difference [SMD], 0.73; 95% CI, −0.65 to 2.11; P = 0.30), or median overall survival (SMD, 0.26; 95% CI, −0.30–0.83; P = 0.36), but results in the increase in 6-month progression-free survival (SMD, 1.71; 95% CI, 0.38–3.04; P = 0.01). There is no increase in grade ≥3 adverse events after adjuvant lomustine treatment (RR, 1.55; 95% CI, 0.84–2.89; P = 0.16) compared with control intervention.ConclusionsAdjuvant lomustine to other chemotherapy may provide no obvious benefits for the treatment of recurrent glioblastoma.

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Addition of lomustine for bevacizumab-refractory recurrent glioblastoma

Cited by 11 publications

References 18 publications

EMP‐induced BBB‐disruption enhances drug delivery to glioma and increases treatment efficacy in rats

EMP‐induced BBB‐disruption enhances drug delivery to glioma and increases treatment efficacy in rats

Carboplatin and Etoposide in Heavily Pretreated Patients with Progressive High-Grade Glioma

The Efficacy and Safety of Adjuvant Lomustine to Chemotherapy for Recurrent Glioblastoma: A Meta-analysis of Randomized Controlled Studies

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