|
Salvage
chemotherapy with CPT-11 for recurrent glioblastoma multiforme
Chamberlain
MC
University
of Southern California, Norris Comprehensive Cancer Hospital, Department of
Neurology, Los Angeles 90033-0804, USA.
chamberl@usc.edu.
Background.
A prospective Phase II study of CPT-11 in adult patients with recurrent
supratentorial glioblastoma multiforme (GBM).
Methods.
Forty patients (25 men, 15 women) ages 32-71 years (median 59), with recurrent
GBM were treated.
All patients had previously been treated with surgery and involved field
radiotherapy (median dose 60 Gy; range 59-60). Additionally, all patients were
treated with adjuvant chemotherapy (BCNU in 20, PCV in 18, Procarbazine in 2).
Twenty-five patients (62%) were on anticonvulsants (phenytoin in 15,
carbamazepine in 10) and 26 patients (65%) were on dexamethasone.
Recurrent disease was defined by neuroradiographic disease progression (>25%
increase in tumor dimensions) using gadolinium-enhanced MR imaging.
The starting dose of CPT-11 was 400 mg/m2 followed in three weeks by 500 mg/m2,
operationally defined as one cycle.
At week 6, all patients were evaluated with MRI and neurological examination.
Results.
All patients were evaluable.
Two doses (one cycle) of CPT-11 were administered to all patients.
CPT-11-related toxicity included: diarrhea (16 patients, 40%); thrombocytopenia
(9 patients, 23%); and neutropenia (6 patients, 15%).
No patient required transfusion nor was treatment for neutropenic fever
required.
No treatment-related deaths were observed.
All patients demonstrated progressive disease following one cycle of CPT-11.
Conclusions.
The lack of response to CPT-11 in this patient group with recurrent GBM suggests
either CPT-11 has minimal activity or CPT-11 doses/schedule utilized in this
study were sub-optimal.
The latter is supported by the modest toxicity seen in this study and the
previously documented enhanced clearance of CPT-11 in patients on
anticonvulsants and dexamethasone.
PMID:
11995820 [PubMed - in process]
Source:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11995820&dopt=Abstract |
