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J Neurooncol. 2013 Apr 6. [Epub ahead of print] Efficacy and safety of second-line fotemustine in elderly patients with recurrent glioblastoma. Santoni M, Scoccianti S, Lolli I, Fabrini MG, Silvano G, Detti B, Perrone F, Savio G, Iacovelli R, Burattini L, Berardi R, Cascinu S. Clinica di Oncologia Medica, AOU "Ospedali Riuniti", Università Politecnica delle Marche, via Tronto 10/A, 60100, Ancona, Italy, mattymo@alice.it. 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/m2 of FTM every week for 3 consecutive weeks (induction phase) and then every 3 weeks (70-100 mg/m2), 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. PMID: 23564276 [PubMed - as supplied by publisher]

Al's Comment:

Fotemustine is a chemo drug in the same class as BCNU and CCNU. It is available all over the world except the USA.   This wasn't a controlled trial so we don't know if it is better than the chemo drugs we have available, but it does show some activity in the elderly after failing with Temodar.


Posted on: 04/12/2013

J Neurooncol. 2013 Apr 6. [Epub ahead of print]
 
Efficacy and safety of second-line fotemustine in elderly patients with recurrent glioblastoma.
 
Santoni M, Scoccianti S, Lolli I, Fabrini MG, Silvano G, Detti B, Perrone F, Savio G, Iacovelli R, Burattini L, Berardi R, Cascinu S.
Clinica di Oncologia Medica, AOU "Ospedali Riuniti", Università Politecnica delle Marche, via Tronto 10/A, 60100, Ancona, Italy, mattymo@alice.it.
 
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/m2 of FTM every week for 3 consecutive weeks (induction phase) and then every 3 weeks (70-100 mg/m2), 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.
 
 PMID: 23564276 [PubMed - as supplied by publisher] 
 

 


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