Phase II trial of carboplatin and etoposide for patients with recurrent high-grade glioma.
We present the results of a phase II trial of carboplatin and etoposide (CE) combination as first-line chemotherapy in patients with recurrent glioblastoma multiforme (GBM) and anaplastic astrocytoma (AA) after surgery and radiotherapy. We assess the activity and the tolerability of this combination. 30 patients with GBM (25) and AA (5) were treated with VP-16 (etoposide) 120 mg m(-2) and CBCDA (carboplatin) 100 mg m(-2) for 3 days every 4 weeks. Moreover, we performed a retrospective analysis of topoisomerase IIalpha gene status using chromogenic in situ hybridisation. The median age was 54 years (21-73 years); Eastern Cooperative Oncology Group performance score was 0-1 in 25 patients and 2 in five patients. All patients had been previously treated with surgical resection (21 radical resections) followed by radiation therapy (40-60 Gy). We observed six (20%) complete responses, three (10%) partial responses and 12 (40%) stable diseases, with a response rate of 30%. The median time to progression was 4 months, while progression-free survival at 6 months was 33.3%. The median survival time was 10 months. Neutropenia occurred in 9 patients: four patients had grade 4, two patients grade 3 and three patients grade 2. In the conclusion of this clinical trial, the CE combination has shown activity in recurrent GBM and AA, with a good toxicity profile. Alterations in the copy number of topoisomerase IIalpha gene seem to be a rare event and in our series do not influence response to the CE combination.
Franceschi
E
E
1Bellaria Hospital, Division of Medical Oncology, Via Altura 3, Bologna 40139, Italy.
Cavallo
G
G
Scopece
L
L
Paioli
A
A
Pession
A
A
Magrini
E
E
Conforti
R
R
Palmerini
E
E
Bartolini
S
S
Rimondini
S
S
Esposti
R Degli
RD
Crinò
L
L
D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use* / Q000633:toxicity; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000473:pathology; D016190:Carboplatin / Q000008:administration & dosage / Q000633:toxicity; D004250:DNA Topoisomerases, Type II / Q000235:genetics / Q000378:metabolism; D004268:DNA-Binding Proteins; D005047:Etoposide / Q000008:administration & dosage / Q000633:toxicity; D005260:Female; D005910:Glioma / Q000188:drug therapy* / Q000201:enzymology / Q000401:mortality / Q000473:pathology; D006801:Humans; D017403:In Situ Hybridization; D008297:Male; D016019:Survival Analysis
D000951:Antigens, Neoplasm; D004268:DNA-Binding Proteins; D005047:Etoposide; D016190:Carboplatin; D004250:DNA Topoisomerases, Type II