Irinotecan Therapy in Adults With Recurrent or Progressive Malignant Glioma

Friedman, Henry S.; Petros, William P.; Friedman, Allan H.; Schaaf, Larry J.; Kerby, Tracy; Lawyer, Jennifer; Parry, Mary; Houghton, Peter J.; Lovell, Shelley; Rasheed, Karima; Cloughsey, Tim; Stewart, Elizabeth; Colvin, O. Michael; Provenzale, James M.; McLendon, Roger E.; Bigner, Darell D.; Cokgor, Ilkcan; Haglund, Michael M.; Rich, Jeremy; Ashley, David M.; Malczyn, Joseph; Elfring, Gary L.; Miller, Langdon L.

doi:10.1200/jco.1999.17.5.1516

Cited by 326 publications

(204 citation statements)

References 36 publications

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“…CPT-11 (Camptosar, Pfizer Pharmaceuticals, Princeton, NJ) has been used for recurrent AO with response rates of 23% and 33% PFS-6, results again less compelling than the present study. 24,[42][43][44][45][46][47] Similarly, carboplatin (with or without teniposide) has been used in several trials for recurrent AO with response rates of 9% to 13% and 35% PFS-6, results less robust than the present analysis. 14,15,48,49 The present retrospective analysis was directed at the 1p19q codeleted AO/AOA population who had failed prior alkylator-based chemotherapy (both TMZ and nitrosoureas) and for whom further treatment appeared warranted.…”

Section: Discussioncontrasting

confidence: 55%

Bevacizumab for recurrent alkylator‐refractory anaplastic oligodendroglioma

Chamberlain

Johnston

2009

Cancer

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BACKGROUND:A retrospective evaluation of single agent bevacizumab was carried out in adults with recurrent alkylator‐refractory 1p19q codeleted anaplastic oligodendrogliomas (AO) with an objective of determining progression‐free survival (PFS). There is no standard therapy for alkylator‐resistant AO, and hence a need exists for new therapies.METHODS:Twenty‐two patients aged 24 to 60 years with recurrent AO were treated. All patients had previously been treated with surgery, radiotherapy, adjuvant chemotherapy (temozolomide, 17; carmustine wafers, 4; carmustine, 1), and 1 salvage regimen (procarbazine, lomustine, and vincristine, 15; temozolomide, 6; carmustine wafers, 1). Eleven patients underwent repeat surgery. Patients were treated at second recurrence with bevacizumab, once every 2 weeks, defined as a single cycle. Neurological evaluation was performed every 2 weeks, and neuroradiographic assessment was made after the initial 2 cycles of bevacizumab and subsequently after every 4 cycles of bevacizumab.RESULTS:A total of 391 cycles of bevacizumab (median, 14.5 cycles; range, 2‐39 cycles) were administered. Bevacizumab‐related toxicity included fatigue (14 patients; 4 grade 3), leukopenia (9; 1 grade 3), anemia (5; 0 grade 3), hypertension (5; 1 grade 3), deep vein thrombosis (4; 1 grade 3), and wound dehiscence (2; 1 grade 3). Fifteen (68%) patients demonstrated a partial radiographic response, 1 (5.0%) demonstrated stable disease, and 6 (27%) demonstrated progressive disease after 2 cycles of bevacizumab. Time to tumor progression ranged from 1 to 18 months (median, 6.75 months). Survival ranged from 3 to 19 months (median, 8.5 months). Six‐month and 12‐month PFS were 68% and 23%, respectively.CONCLUSIONS:Bevacizumab demonstrated efficacy and acceptable toxicity in this cohort of adults with recurrent 1p19q codeleted alkylator‐refractory AO. Cancer 2009. © 2009 American Cancer Society.

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Section: Discussioncontrasting

confidence: 55%

Bevacizumab for recurrent alkylator‐refractory anaplastic oligodendroglioma

Chamberlain

Johnston

2009

Cancer

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“…16 Its impressive activity against human GBM, medulloblastoma, and ependymoma xenografts in athymic nude mice suggests that it could be an important new addition to the therapy for central nervous system tumors. 13,17 An initial study 15 of CPT-11 was conducted in patients with glioma who received a dose of 125 mg/m 2 for 4 weeks followed by a 2-week rest. The intent-to-treat response rate was 15% (95% CI, 6 -24), and activity was observed in patients with GBM and anaplastic astrocytoma.…”

Section: Discussionmentioning

confidence: 99%

“…13 has been shown to have activity in the treatment of recurrent malignant glioma using a dose of 125 mg/m 2 weekly for 4 weeks followed by a 2-week rest. 14,15 It was thought that an every-3-week dosing schedule might be tolerated better by patients and possibly may prove more beneficial.…”

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confidence: 99%

Irinotecan Treatment for Recurrent Malignant Glioma Using an Every-3-Week Regimen

Cloughesy

Filka

Nelson

et al. 2002

American Journal of Clinical Oncology

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“…The majority of salvage therapies are associated with low response rates and a marginal benefit on progression-free and overall survival (OS) rates. Numerous agents have been tried in this setting, offering low response rates ranging from 5 to 20% and median OS between 5 and 7.5 months (2)(3)(4)(5).…”

Section: Introductionmentioning

confidence: 99%

Carboplatin and bevacizumab for recurrent malignant glioma

et al. 2012

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Abstract. Over 65,000 primary brain tumors are diagnosed annually in the US alone. Malignant gliomas represent more than one-third of such cases. Despite advances in neuroimaging, surgical techniques, radiotherapy and chemotherapy, the survival rate of this disease remains poor. The introduction of agents which disrupt the function of vascular endothelial growth factor (VEGF) and its receptors to glioma therapy has resulted in an unusually high percentage of patients experiencing radiographic responses. Bevacizumab, approved by the Food and Drug Administration for the treatment of recurrent glioblastoma in 2009, has changed the field of neuro-oncology. The drug has been utilized as a single agent and in combination with the classic cytotoxic agents typically applied in this setting. Numerous studies have reported high response rates and encouraging extensions of time-to-progression. The optimal schedule and combination of bevacizumab with alternative drugs has not been identified. The current study presents the results of a retrospective analysis of the combination therapy utilizing bevacizumab with the alkylating agent carboplatin in patients with recurrent malignant glioma.

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Irinotecan Therapy in Adults With Recurrent or Progressive Malignant Glioma

Cited by 326 publications

References 36 publications

Bevacizumab for recurrent alkylator‐refractory anaplastic oligodendroglioma

Bevacizumab for recurrent alkylator‐refractory anaplastic oligodendroglioma

Irinotecan Treatment for Recurrent Malignant Glioma Using an Every-3-Week Regimen

Carboplatin and bevacizumab for recurrent malignant glioma

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