title: Nimustine (ACNU) plus teniposide (VM26) in recurrent glioblastoma.
abstract: BACKGROUND
  In a previous trial (NOA-01), the combination of nimustine and teniposide showed efficacy in previously untreated glioblastoma (GBM). After establishing temozolomide as standard first-line therapy in GBM patients, the nimustine (ACNU)/teniposide (VM-26) combination has been employed as salvage chemotherapy for recurrent GBM. However, data on the toxicity and efficacy of this regimen in recurrent GBM are lacking.
  
  
  METHODS
  In two neurooncological centers, all patients with recurrent GBM treated with nimustine (90 mg/m(2), day 1/42) and teniposide (45-70 mg/m(2), days 1-3/42) were analyzed retrospectively for progression-free survival (PFS), overall survival (OS) and toxicity.
  
  
  RESULTS
  Thirty-five patients (median age 51 years, range 25-71 years) were identified. Six months after chemotherapy initiation, PFS was 29% and the median OS 6 months; 23% of patients were alive > or = 1 year after initiation of nimustine-teniposide chemotherapy. Grade 4 hematotoxicity was observed in 12 of 35 patients (34%) and in 14 of 83 evaluable chemotherapy courses (17%).
  
  
  CONCLUSIONS
  The benefit of the nimustine-teniposide combination is moderate in patients with recurrent GBM. The data support the efficacy of the nimustine-teniposide chemotherapy, but the rate of high-grade hematotoxicity is increased.
authors.affiliation: Department of Neurology, Clinical Neurooncology Unit, University of Bonn, Bonn, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Glas
authors.forename: T
authors.initials: T
authors.lastname: Hundsberger
authors.forename: M
authors.initials: M
authors.lastname: Stuplich
authors.forename: D
authors.initials: D
authors.lastname: Wiewrodt
authors.forename: D
authors.initials: D
authors.lastname: Kurzwelly
authors.forename: B
authors.initials: B
authors.lastname: Nguyen-Huu
authors.forename: K
authors.initials: K
authors.lastname: Rasch
authors.forename: U
authors.initials: U
authors.lastname: Herrlinger
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D015376:Nimustine / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D013713:Teniposide / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D015376:Nimustine; D013713:Teniposide