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Carboplatin and etoposide (CE) chemotherapy in patients with recurrent or progressive oligodendroglial tumors.

Al Musella's Comments: (This is his personal views and are not necessarily the views of the Musella Foundation!)


Posted on: 06/08/2004

Carboplatin and etoposide (CE) chemotherapy in patients with recurrent or progressive oligodendroglial tumors.

Meeting: 2004 ASCO Annual Meeting
Category: Central Nervous System Tumors
SubCategory: CNS Tumors

Abstract No: 1562
Author(s): L. Scopece, G. Cavallo, E. Palmerini, E. Franceschi, A. Paioli, F. Spagnolli, S. Rimondini, R. Conforti, R. Degli Esposti, L. Crino; Bellaria Hospital, Bologna, Italy

Background: Oligodendroglial tumors are chemosensitive diseases, and the response rate (RR) with first line chemotherapy is in the range of 40 to 70%. Second line chemotherapy with temozolomide showed a RR of 40-60%. However TTP with these therapies cannot be considered satisfactory and other active treatments are necessary. Etoposide (VP-16) is a topoisomerase IIĆ” inhibitor which penetrates the CNS and has activity against a variety of CNS tumors, showing a synergistic effect with cisplatin or carboplatin, either in vitro and in vivo.

Methods: In this phase II trial primary endpoint was to evaluate the RR following first and second line Carboplatin and Etoposide (CE) regimen in patients with recurrent/progressive oligodendroglioma (O2), anaplastic oligodendroglioma (O3), oligoastrocytoma (OA2) and anaplastic oligoastrocytoma (OA3). PFS, TTP, overall survival and toxicity were evaluated as secondary endpoints. Patients were treated with first or second line carboplatin AUC 5 on day 1 and etoposide 120 mg/m2 on days 1 to 3 every 28 days. Results: 18 pts were included in the study (median age 45.5 yrs, range 28-65 y; median KPS 90, range 70-100; 1 O2, 1 OA2, 8 O3 and 8 OA3). Twelve patients were treated with first line CE, and in 6 pts the treatment was given as a second line. All pts were evaluable for response: 1 CR (5.6%) and 5 PR (27.8%) were obtained with a RR of 33.4%. Eight pts (44.4%) were stable for more than two months. At the time of analysis 14 patients had progression while 4 patients were progression free. The median TTP was 8 months. The PFS at 6 and 12 months were 70.5% and 37.5% respectively; in responders these percentages were 100% and 80%, respectively. A total of 78 cycles of CE were administered (median 4, range 1-7). When given in first line, CE regimen showed a RR of 41.1% (1CR and 4PR). Toxicity was mainly hematological, with grade 3-4 neutropenia in 2 (11.1%) pts. Mild nausea and vomiting were common.

Conclusions: In this trial the CE regimen has shown activity and a good toxicity profile. Further studies with biological correlations with LOH of 1p and 19q are warranted.

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