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Complete
response of a recurrent, multicentric malignant glioma in a patient treated with
phenylbutyrate
Baker
MJ, Brem S, Daniels S, Sherman B, Phuphanich S
Neuro-Oncology
Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
33612-9497, USA
Sodium
phenylbutyrate is a biological-response modifier that acts as a dose-dependent
inhibitor of glioma cell proliferation, migration, and invasiveness in vitro,
possibly by inhibition of urokinase and c-myc pathways.
Despite its biological activity in vitro, there have not been any prior reports
of efficacy in the treatment of human malignant gliomas.
We report a 44-year-old female with a recurrent, multicentric, malignant glioma
who experienced a durable remission lasting more than four years.
The patient initially presented with seizures caused by a biopsy-proven
anaplastic astrocytoma of the frontal lobe.
The patient was treated with radiation therapy and Procarbazine-CCNU-Vincristine
(PCV).
However, the tumor progressed and extended to the corpus callosum with midline
shift, refractory to four cycles of continuous 72-h infusion of BCNU/Cisplatinum.
Additional enhancing lesions appeared in the left frontal and left temporal
lobes.
The patient was started on sodium phenylbutyrate, 18 g daily in three divided
oral doses, and reduced to 9 g/day and eventually to 4.5 g/day to eliminate
mild, reversible side effects.
Four years later, the patient has a KPS functional score of 100%.
Phenylbutyrate is a well-tolerated, oral agent that shows potential for the
treatment of malignant gliomas.
Further studies should be considered to identify a subset of patients that have
tumors sensitive to phenylbutyrate, either as a single agent or in combination
with radiation therapy or other chemotherapeutic agents.
PMID:
12241121 [PubMed - in process]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12241121&dopt=Abstract
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