Phase II study of continuous infusion carmustine and cisplatin followed by cranial irradiation in adults with newly diagnosed high-grade astrocytoma.

Abstract

This chemotherapy regimen appears to have significant activity and may prolong survival in adults with newly diagnosed high-grade astrocytoma.

Chemotherapy for high-grade gliomas

“…Neoadjuvant chemotherapy has the potential to greatly enhance the discovery of truly active agents as well as the early identification of ineffective therapies in a disease where chemotherapy has been only marginally effective. In a phase II setting, Grossman et al administered BCNU and CDDP as a 72-h continuous intravenous infusion prior to radiation therapy (Grossman et al, 1997). Of the 52 patients studied, 42% had a partial response and 53% had stable disease.…”

Radiotherapy followed by adjuvant temozolomide with or without neoadjuvant ACNU-CDDP chemotherapy in newly diagnosed glioblastomas: a prospective randomized controlled multicenter phase III trial

“…The high risk of myelosuppression by nitrosourea is a well-known problem, and we have previously experienced such high toxicity profiles [5,7,16]. Moreover, many studies have reported that the hematological toxicities induced by nitrosourea are well tolerated by the majority of patients [4][5][6][7]18]. In the past and despite its toxicity, use of this kind of chemotherapeutic agent was justified because it was the only drug for extending survival in this devastating disease.…”

“…Synergy in the anticancer effects of nitrosourea and temozolomide has been demonstrated in a phase II trial for recurrent glioblastoma [13]. The idea of combining continuous infusion of a lipophilic drug such as nitrosourea with a hydrophilic agent such as CDDP for treatment of malignant glioma was developed as a potential improved anticancer strategy [4,15]. In Korea and Japan, ACNU rather than BCNU and CCNU has been widely used for high-grade glioma treatment because of its easy availability [7].…”

“…These drugs were usually used with hydrophilic agents such as cisplatin (CDDP) to increase its anticancer effect [4]. The authors also had reported several protocols using ACNU and CDDP for treatment of glioblastoma, and reported the efficacy and feasibility of their usage as neoadjuvant chemotherapy [5][6][7].…”

Pre-radiation chemotherapy with ACNU-CDDP in patients with newly diagnosed glioblastoma: A retrospective analysis

“…The idea of combining the continuous infusion of a lipid-soluble drug with a water-soluble agent for malignant glioma was developed as a potential strategy [7,10,12,13] . This tactic is based on the observation that even hydrophilic agents can cross the blood-brain barrier (BBB) when a sustained blood level is continuously maintained [14] , and the anticancer effect is even The number of cycles of each treatment are shown in parentheses.…”