title: Efficacy and safety of second-line fotemustine in elderly patients with recurrent glioblastoma.
abstract: Fotemustine (FTM) is a common treatment option for glioblastoma patients refractory to temozolomide (TMZ). Although elderly patients represent a large component of glioblastoma population, the feasibility and the efficacy of second-line FTM are not available in those patients.We retrospectively analyzed the records of glioblastoma patients older than 65 years, receiving FTM at a dose of 70-100 mg/m(2) of FTM every week for 3 consecutive weeks (induction phase) and then every 3 weeks (70-100 mg/m(2)), as second-line treatment.Between January 2004 and December 2011, 65 glioblastoma patients (median age, 70 years; range, 65-79 years) were eligible for this analysis. Sixty-five patients received a total of 364 FTM cycles, with a median of 4 cycles for each patient. After induction, we observed 1 complete response (1.5 %), 12 partial responses (18.5 %), 18 stable diseases (27.7 %), and 34 patients' progressions (47.7 %). Disease control rate was 43.1 %. Median survival from the beginning of FTM therapy was 7.1 months, while the median progression-free survival was 4.2 months, and the 6-months progression free survival rate was 35.4 %. The most relevant grade 3-4 toxicity events were thrombocytopenia (15.3 %) and neutropenia (9.2 %). In the univariate and multivariate analysis, time from radiotherapy to FTM, number of TMZ and FTM cycles and disease control resulted independent prognostic factors.This study showed that FTM is a valuable therapeutic option for elderly glioblastoma patients, with a safe toxicity profile.
authors.affiliation: Clinica di Oncologia Medica, AOU Ospedali Riuniti, Università Politecnica delle Marche, via Tronto 10/A, 60100 Ancona, Italy. mattymo@alice.it
authors.forename: Matteo
authors.initials: M
authors.lastname: Santoni
authors.forename: Silvia
authors.initials: S
authors.lastname: Scoccianti
authors.forename: Ivan
authors.initials: I
authors.lastname: Lolli
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Fabrini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Silvano
authors.forename: Beatrice
authors.initials: B
authors.lastname: Detti
authors.forename: Franco
authors.initials: F
authors.lastname: Perrone
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Savio
authors.forename: Roberto
authors.initials: R
authors.lastname: Iacovelli
authors.forename: Luciano
authors.initials: L
authors.lastname: Burattini
authors.forename: Rossana
authors.initials: R
authors.lastname: Berardi
authors.forename: Stefano
authors.initials: S
authors.lastname: Cascinu
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality; D009607:Nitrosourea Compounds / Q000627:therapeutic use*; D009943:Organophosphorus Compounds / Q000627:therapeutic use*; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D009607:Nitrosourea Compounds; D009943:Organophosphorus Compounds; C054368:fotemustine
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