Pegylated liposomal doxorubicin in recurrent malignant glioma: analysis of a case series.
BACKGROUND
Recurrent malignant glioma has a dismal prognosis, and therapeutic options are scarce. After previous potentially encouraging reports on liposomal pegylated doxorubicin (PEG-DOX) in this setting, PEG-DOX was applied to patients with recurrent malignant glioma in an institutional series.


METHODS
In a retrospective analysis, 49 patients with recurrent high-grade glioma (WHO III, n = 18; WHO IV, n = 31) were treated with PEG-DOX (days 1 and 14/28, 20 mg/m(2), n = 26) alone or in combination with temozolomide (days 1-5/28, 200 mg/m(2), n = 23). The response rate, progression-free survival and overall survival were evaluated.


RESULTS
The rate of progression-free patients at 6 months after initiation of therapy was 27% (WHO III, 33%; WHO IV, 23%). The median overall survival (mOS) after initiation of PEG-DOX (monotherapy and combination therapy) was 8 months (WHO III, 16 months; WHO IV, 7 months). The mOS after initiation of PEG-DOX monotherapy was 8 months, and after initiation of combination therapy, 10 months. Both regimens were well tolerated, with the main side effect being hematologic toxicity (grade 1-2, 8%; grade 3-4, 18%).


CONCLUSIONS
These data demonstrate the safety and moderate efficacy of PEG-DOX +/- temozolomide therapy in recurrent malignant glioma. The potential of this nonalkylating chemotherapy should be further explored.
Glas
Martin
M
Department of Neurology, University of Regensburg, Regensburg, Germany. martin.glas@ukb.uni-bonn.de
Koch
Horst
H
Hirschmann
Birgit
B
Jauch
Tanja
T
Steinbrecher
Andreas
A
Herrlinger
Ulrich
U
Bogdahn
Ulrich
U
Hau
Peter
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000628:therapy; D003131:Combined Modality Therapy; D004317:Doxorubicin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005910:Glioma / Q000188:drug therapy* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D012189:Retrospective Studies
D000903:Antibiotics, Antineoplastic; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin