title: Carmustine (BCNU) plus Teniposide (VM26) in recurrent malignant glioma.
abstract: BACKGROUND
  After the failure of radiotherapy and temozolomide, there is no established standard therapy for patients with recurrent glioblastoma (GBM). Based on the promising data of a previous trial (NOA-01) for primary GBM and some retrospective case series for GBM recurrence, the combination of nimustine and teniposide (VM26) was commonly used in this setting. When nimustine was no longer available in Europe, we switched to intrvaveneous carmustine (BCNU). Data on the toxicity and efficacy of BCNU and VM26 in recurrent GBM are lacking.
  
  
  METHODS
  In our neurooncological center, all patients with recurrent GBM or with progressed glioma and a typical MRI lesion suggesting GBM treated with BCNU (130-150 mg/m(2), day 1/42) and VM26 (45-60 mg/m(2), days 1-3/42) were analyzed retrospectively for progression-free survival, overall survival and toxicity.
  
  
  RESULTS
  Fifteen patients (median age 52 years) were identified. Median progression-free survival was 2 months and median overall survival was 4 months. Two patients (14%) developed grade 3/4 hematotoxicity. Nonhematological toxicity ≥grade 3 was not observed.
  
  
  CONCLUSIONS
  Our data do not support the application of BCNU/VM26 in patients with late stages of recurrent GBM.
authors.affiliation: Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Center, Bonn, Germany.
authors.forename: Frederic
authors.initials: F
authors.lastname: Mack
authors.forename: Niklas
authors.initials: N
authors.lastname: Schäfer
authors.forename: Sied
authors.initials: S
authors.lastname: Kebir
authors.forename: Moritz
authors.initials: M
authors.lastname: Stuplich
authors.forename: Christina
authors.initials: C
authors.lastname: Schaub
authors.forename: Michael
authors.initials: M
authors.lastname: Niessen
authors.forename: Björn
authors.initials: B
authors.lastname: Scheffler
authors.forename: Ulrich
authors.initials: U
authors.lastname: Herrlinger
authors.forename: Martin
authors.initials: M
authors.lastname: Glas
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality; D002330:Carmustine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005910:Glioma / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D013713:Teniposide / Q000008:administration & dosage
chemical_list: D013713:Teniposide; D002330:Carmustine