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13-cis-Retinoic acid in the treatment
of recurrent glioblastoma multiforme
Siew-Ju See, Victor A. Levin, W.-K. Alfred Yung, Kenneth R. Hess, Morris
D. Groves
Departments of
Neuro-Oncology (S.-J.S., V.A.L., W.-K.A.Y., M.D.G.) and Biostatistics (K.R.H.),
University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA.
Basic science and clinical investigations have demonstrated that 13-cis-retinoic
acid (cRA) has activity against malignant gliomas.
To assess its effectiveness in the setting of recurrent glioblastoma multiforme
(GBM), we performed a retrospective analysis of the medical records and
neuroimaging results of patients with recurrent GBM who were treated with
cRA.
The toxicity profile of cRA, response, and effect on progression-free survival
from initiation of treatment were end points of our analysis.
Eighty-two of 85 patients with a median age of 51 years received at least 1 full
cycle of cRA.
At the initiation of cRA treatment, the median Karnofsky performance score was
80.
All patients had failed conventional radiotherapy.
Seven patients were chemonaïve, whereas 75 patients had received some form of
chemotherapy.
Radiographic partial responses, minor responses, and stable disease were seen in
4%, 8%, and 34% of patients, respectively.
Two patients were not assessable.
Progression-free survival and overall survival after initiation of cRA were 10.0
and 24.6 weeks, respectively.
Sixmonth progression-free survival was 19% for the entire group.
Grade 3 or 4 toxicity developed in 14 patients (16%), one of whom developed
pancreatitis and died.
The results of this study demonstrate only modest efficacy for cRA therapy in
this cohort of heavily pretreated patients with recurrent GBM.
This data supports the use of cRA in such patients, but its further evaluation
in larger, prospective, controlled studies with or without other noncytotoxic
and cytotoxic agents may be warranted.
© 2004 Duke University Press
Source: http://zerlina.ingentaselect.com/vl=10499664/cl=44/nw=1/rpsv/cgi-bin/linker?ini=dup_no&reqidx=/cw/dup/15228517/v6n3/s9/p253
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