Single-agent chemotherapy of brain tumors. A five-year review.
Identification of effective single chemotherapeutic agents for brain tumors must precede the rational use of multiple drug combinations. In phase 2 trials beginning in 1968, 158 patients with intrinsic brain tumors (mostly recurrent malignant astrocytomas) were considered evaluable. The larger trials with more effective drugs produced these results: carmustine (BCNU) response rate, 47%, with median duration of nine months; lomustine (CCNU), 44%, with median duration of six months; procarbazine hydrochloride, 52%, with median duration six months; carmustine and vincristine sulfate combined, 44%, with median duration of only four months; and BIC (5-[3,3-bis(2-chloroethyl)-1-triazeno]imidazole-4-carboxamide), 38%, with median duration of five months. Administration of glucocorticoids was not found to bias the frequency of response. Forty-seven patients, 26 of whom had responded to the initial drug, received a second drug. Among 26 patients who were evaluable, only four responded to the second drug.
D001254:Astrocytoma / Q000188:drug therapy; D001855:Bone Marrow Diseases / Q000139:chemically induced; D001932:Brain Neoplasms / Q000188:drug therapy*; D002330:Carmustine / Q000009:adverse effects / Q000627:therapeutic use*; D005910:Glioma / Q000188:drug therapy; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use; D008130:Lomustine / Q000009:adverse effects / Q000627:therapeutic use*; D008527:Medulloblastoma / Q000188:drug therapy; D008545:Melanoma / Q000188:drug therapy; D009607:Nitrosourea Compounds / Q000627:therapeutic use*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D011344:Procarbazine / Q000009:adverse effects / Q000627:therapeutic use; D013997:Time Factors; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use*
D007093:Imidazoles; D009607:Nitrosourea Compounds; D011344:Procarbazine; D014750:Vincristine; D008130:Lomustine; D002330:Carmustine