Response of recurrent anaplastic ependymoma to a combination of tamoxifen and isotretinoin

Rojas-Marcos, Íñigo; Calvet, D.; Janoray, P.; Delattre, J.

doi:10.1212/01.wnl.0000082384.15848.fa

Cited by 14 publications

(8 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Review of the literature showed a case report demonstrating a CR and a median PFS of 17 months in an adult patient with recurrent anaplastic intracranial ependymoma after treatment with tamoxifen and isotretinoin [ 25 ]. Beyond classical CT, Green et al reported outcome data in 8 recurrent WHO grade II and III intracranial ependymomas which were treated with bevacizumab at time of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy for intracranial ependymoma in adults

et al. 2016

View full text Add to dashboard Cite

BackgroundEpendymal tumors in adults are rare, accounting for less than 4 % of primary tumors of the central nervous system in this age group. The low prevalence of intracranial ependymoma in adults limits the ability to perform clinical trials. Therefore, treatment decisions are based on small, mostly retrospective studies and the role of chemotherapy has remained unclear.MethodsWe performed a retrospective study on 17 adult patients diagnosed with intracranial World Health Organisation grade II or III ependymoma, who were treated with chemotherapy at any time during the disease course. Benefit from chemotherapy was estimated by applying Macdonald criteria. Progression-free (PFS) and overall survival (OS) were calculated from start of chemotherapy, using the Kaplan-Meier method.ResultsEleven patients had supratentorial and 6 infratentorial tumors. Ten patients were treated with temozolomide (TMZ), 3 with procarbazine/lomustine/vincristine (PCV), 3 with platinum-based chemotherapy and 1 patient received epirubicin/ifosfamide. Response rates were as follows: TMZ 8/10 stable disease; PCV 3/3 stable disease; platinum-based chemotherapy 1/3 partial response; epirubicin/ifosfamide 1/1 complete response. PFS rates at 6, 12 and 24 months were 52.9, 35.3 and 23.5 %. OS rates at 6, 12 and 24 months were 82.4, 82.4 and 70.1 %. There was no indication for a favourable prognostic role of O6-methylguanyl-DNA-methyltransferase (MGMT) promoter methylation which was detected in 3/12 investigated tumors.ConclusionsSurvival outcomes in response to chemotherapy in adult intracranial ependymoma patients vary substantially, but individual patients may respond to any kind of chemotherapy. There were too few patients to compare survival data between chemotherapeutic subgroups.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2323-0) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionmentioning

confidence: 99%

Chemotherapy for intracranial ependymoma in adults

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The pediatric literature supports the use of cisplatin over carboplatin; however, this has not been addressed in the adult patient population. There are anecdotal reports from investigators using a variety of chemotherapy regimens including irinotecan, ifosfamide, idarubicin, and tamoxifen in combination with isotretinoin [47].…”

Section: Intracranial Tumorsmentioning

confidence: 99%

Ependymomas in Adults

Gilbert

Rudà

Soffietti

2010

Curr Neurol Neurosci Rep

140

119

View full text Add to dashboard Cite

Ependymomas are rare primary central nervous system tumors in adults. They occur most commonly in the spinal cord, where histopathologic evaluation is critical to differentiate the grade I myxopapillary ependymoma from the grade II ependymoma or grade III anaplastic ependymoma. Brain ependymomas are either grade II or III. Treatment for all grades and types includes maximum surgical resection. For myxopapillary ependymoma, complete removal while maintaining capsule integrity may be curative. Some grade II ependymomas may be observed carefully after imaging confirms complete resection, but grade III tumors require adjuvant radiation treatment. Radiation commonly is given to the region of tumor, except in cases in which there is imaging or cerebrospinal fluid evidence of tumor dissemination. Chemotherapy has not been studied extensively, although most reports suggest only modest benefit. Ongoing laboratory studies have uncovered important signal transduction pathways that may be better therapeutic targets, leading to the development of clinical trials using targeted agents.

show abstract

“…The second EPN-selective drugs class identified was retinoids, where all 3 retinoids tested (tretinoin, isotretinoin and bexarotene) were significantly more potent in EPN than non-EPN cell lines (Table 1A). Research on the effect of retinoids in EPN is limited, with a single case report of an anaplastic EPN regressing in response to isotretinoin in an adult(18). Further investigation of retinoid treatment in EPN is therefore warranted.…”

Section: Resultsmentioning

confidence: 99%

Identification of FDA-Approved Oncology Drugs with Selective Potency in High-Risk Childhood Ependymoma

Donson

Amani

Warner

et al. 2018

Molecular Cancer Therapeutics

View full text Add to dashboard Cite

Children with ependymoma (EPN) are cured in less than 50% of cases, with little improvement in outcome over the last several decades. Chemotherapy has not affected survival in EPN, due in part to a lack of preclinical models that has precluded comprehensive drug testing. We recently developed two human EPN cell lines harboring high-risk phenotypes which provided us with an opportunity to execute translational studies. EPN and other pediatric brain tumor cell lines were subject to a large-scale comparative drug screen of FDA-approved oncology drugs for rapid clinical application. The results of this study were combined with prediction of drug sensitivity to identify EPN-selective compounds, which were validated by dose curve and time course modeling. Mechanisms of EPN-selective antitumor effect were further investigated using transcriptome and proteome analyses. We identified three classes of oncology drugs that showed EPN-selective antitumor effect, namely, (i) fluorinated pyrimidines (5-fluorouracil, carmofur, and floxuridine), (ii) retinoids (bexarotene, tretinoin and isotretinoin), and (iii) a subset of small-molecule multireceptor tyrosine kinase inhibitors (axitinib, imatinib, and pazopanib). Axitinib's antitumor mechanism in EPN cell lines involved inhibition of PDGFRα and PDGFRβ and was associated with reduced mitosis-related gene expression and cellular senescence. The clinically available, EPN-selective oncology drugs identified by our study have the potential to critically inform design of upcoming clinical studies in EPN, in particular for those children with recurrent EPN who are in the greatest need of novel therapeutic approaches. .

show abstract

Response of recurrent anaplastic ependymoma to a combination of tamoxifen and isotretinoin

Cited by 14 publications

References 11 publications

Chemotherapy for intracranial ependymoma in adults

Chemotherapy for intracranial ependymoma in adults

Ependymomas in Adults

Identification of FDA-Approved Oncology Drugs with Selective Potency in High-Risk Childhood Ependymoma

Contact Info

Product

Resources

About