An Overview of Fotemustine in High-Grade Gliomas: From Single Agent to Association with Bevacizumab

Abstract

Fotemustine is a third-generation nitrosourea showing efficacy in various types of tumors such as melanoma and glioma. We reviewed the most important studies on fotemustine treatment in glioma patients analyzing its pharmacological profile and its activity and safety. Fotemustine was used as single agent or in association with new targeted drugs such as bevacizumab; fotemustine was used both as first-line chemotherapy before temozolomide era and in refractory-temozolomide patients during temozolomide era. Finally, analyzing and comparing the activity and safety of fotemustine alone or in combination with bevacizumab versus other nitrosoureas such as lomustine, we may suggest that the combination treatment with bevacizumab and fotemustine may be active and tolerable in patients with high grade gliomas.

Biweekly fotemustine schedule for recurrent glioblastoma in the elderly: activity and toxicity assessment of a multicenter study

“…Currently, there is a lack of standard treatment strategies for elderly GBM patients. Several studies have demonstrated the efficacy of FTM against newly diagnosed or recurrent high-grade gliomas [32][33][34][35]. Previous trials investigating FTM reported an OS of 9-20 months, PFS of 4-9.1 months, PFS-6 of 27-48.5% and DCR of 47.5-62% [18][19][20][21][22][23][24][25].…”

Research progress of anti-glioma chemotherapeutic drugs (Review)

“…This causes high cytotoxicity, induces DNA double-strand break and prevents DNA replication and transcription to finally result in cell apoptosis and necrosis ( 80 ). Nitrosourea chemotherapeutic drugs have myelosuppression and hematological toxicity ( 80 , 81 ). Due to the limited efficacy of chemotherapeutic drugs when applied alone, previous studies that investigated the effects of multiple combination therapies revealed that the resultant efficacy is superior compared with that in chemotherapy alone ( 30 , 80 , 82 ).…”

Trends in Malignant Glioma Monoclonal Antibody Therapy

“…That implies not the bevacizumab and fotemustine in-effectiveness per se , but lack of breakthrough achievements against a ground of previous studies. A double-agent regimen applied to grade III glioma resulted in PFS of 5 months and median OS of 8.6 months [ 37 ].…”