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Suramin and
radiotherapy in newly diagnosed glioblastoma: Phase 2 NABTT CNS Consortium study
John J. Laterra, Stuart A. Grossman, Kathryn A. Carson, Glenn J. Lesser, Fred
H. Hochberg, Mark R. Gilbert
The Sidney Kimmel Comprehensive
Cancer Center at Johns Hopkins, Baltimore, MD 21231 (J.J.L., S.A.G., K.A.C);
Department of Hematology and Oncology, Wake Forest University Baptist Medical
Center, Winston-Salem, NC 27157
(G.J.L.); Brain Tumor Center, Massachusetts General Hospital, Boston, MA 02114
(F.H.H.); and Department of Neuro-Oncology, The University of Texas M.D.
Anderson Cancer Center, Houston, TX 77030 (M.R.G.); USA
Suramin is a polysulfonated
naphthylurea that inhibits the function of growth factors and growth factor
receptors implicated in glioma progression, angiogenesis, and
radioresistance.
The safety and benefits of combining inhibitors of angiogenesis and growth
factors with cytotoxic therapies in patients with neoplasms of the central
nervous system remain unclear.
The objectives of this phase 2 study were to determine the safety of
administering suramin with standard cranial radiotherapy (RT) and to estimate
survival using this approach in patients with newly diagnosed glioblastoma
multiforme (GBM).
Fifty-five patients with newly diagnosed GBM (Karnofsky performance status
≥ 60) were enrolled in this multicenter phase 2 study.
Patients received suramin by a conventional intermittent fixed-dosing regimen
for 1 week prior to and during cranial RT (60 Gy in 30 fractions, weeks
2-7).
Patients with stable or responsive disease at week 18 received an additional 4
weeks of suramin (weeks 19-22).
The median survival for suramin-treated patients was 11.6 months, with 1-year
and 18-month survival rates of 49% (95% confidence interval [CI], 36%-62%) and
18% (95% CI, 8%-28%), respectively.
Overall, 55% of the patients (30/55) had greater than grade 2 toxicity at least
possibly related to suramin therapy.
Two patients died of possibly related neurologic events (i.e., stroke, elevated
intracranial pressure).
Otherwise, toxicities were generally transient and self-limited.
Administration of suramin using an intermittent fixed-dosing regimen during
cranial RT was generally well tolerated.
However, overall survival is not significantly improved when compared with the
New Approaches to Brain Tumor Therapy GBM database or other comparable patient
populations.
© 2003 Duke University Press
Source: http://dandini.ingentaselect.com/cgi-bin/linker?ini=dup_no&reqidx=/cw/dup/15228517/v6n1/s3/p15
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