Treatment > Carboplatin

Meeting Abstract

Carboplatin and VM-26 as third-line chemotherapy in patients with oligodendroglioma refractory to PCV and temozolomide

U. Basso, F. Vastola, L. M. Pasetto, A. Scola, M. Ermani, M. Cacciacarne, F. Sala, A. Talacchi, M. K. Paris, A. A. Brandes

Dept Medical Oncology, Az Osp-Universita, PADOVA, Italy; Department of Neurological Sciences, PADOVA, Italy; Department of Neurosurgery, VERONA, Italy.

Introduction. Malignant gliomas with the oligodendroglial phenotype are chemosensitive tumors, and standard first line chemotherapy with PCV obtains a response rate (RR) of 60-70% with a Time To Progression (TTP) of 12-18 months for responders; at relapse/progression second line chemotherapy with temozolomide is followed by a RR of 43-63%, and a median TTP of 6.7 months.
To date no standard third line chemotherapy is available, although it might be indicated.

Objectives. To evaluate RR, TTP, and toxicity from the administration of carboplatin and VM-26 in adult patients (pts) with oligodendroglioma (OD) or mixed oligoastrocytoma (OA) progressive or refractory to radiotherapy, PCV and temozolomide chemotherapy.

Methods. 23 pts (median age 47 years, range 28 -64.4 years; median KPS 80, range 40-90) with measurable contrast-enhancing disease at MRI, 17 of whom were OD, were considered eligible for the study, and were treated with carboplatin (350 mg/m² on day 1) and VM-26 (50 mg/m² on days 1 to 3), every 28 days.

Results. 2 pts (8.7%) had PR, and 12 pts (52%) had SD.
Median TTP was 4.5 months, and PFS at 6 months was 34.2% (CI 95%= 19-61%), with 50% (CI 95%= 32-79%) of pts alive at 12 months after the start of therapy.
OD histology was predictive for better response (p=0.02) and for survival (p=0.005).
Toxicity: A total of 103 cycles were administered (on average 4.4 cycles per pt, range 1-9).
Toxicity was mainly hematological, with neutropenia and thrombocytopenia G3 in 2 (8.7%) and 2 (8.7%) pts, respectively.
One pt had a deep vein thrombosis, one a gluteal abscess concomitant with G3 neutropenia.
Dose reduction to 75% was required in 3 pts (13%), while 18 cycles (17.4%) were delayed for 1 or 2 weeks due to hematological toxicity.

Conclusion. Combined carboplatin and VM-26 is followed by a moderate response rate, incurs manageable toxicity and appears to delay progression in patients with heavily pretreated oligodendroglial tumors.

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