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Tumour Treating Fields (TTFields) in combination with lomustine and temozolomide in patients with newly diagnosed glioblastoma.

Al's Comment:

 There was a high chance of toxcicity - but the results look pretty good.  Might be worth trying to add lomustine to the standard of temodar and optune.

 


Posted on: 12/16/2019

. J Cancer Res Clin Oncol. 2019 Dec 11. doi: 10.1007/s00432-019-03106-8. [Epub ahead of print]

Tumour Treating Fields (TTFields) in combination with lomustine and temozolomide in patients with newly diagnosed glioblastoma.

Lazaridis L1,2,3,4, Schäfer N5, Teuber-Hanselmann S6, Blau T6, Schmidt T1,2,3,4, Oster C1,2,3,4, Weller J5, Tzaridis T5, Pierscianek D7,3,4, Keyvani K6, Kleinschnitz C8, Stuschke M9, Scheffler B2, Deuschl C10, Sure U7,3,4, Herrlinger U5, Kebir S1,2,3,4, Glas M11,12,13,14.
 
Author information:
1. Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
2. DKFZ-Division Translational Neurooncology at the West German Cancer Centre (WTZ), German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
3. West German Cancer Centre (WTZ), University Hospital Essen, University Duisburg-Essen, Essen, Germany.
4. German Cancer Consortium, Partner Site University Hospital Essen, Essen, Germany.
5. Division of Clinical Neurooncology, Department of Neurology, University of Bonn Medical Centre, Bonn, Germany.
6. Department of Neuropathology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
7. Department of Neurosurgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
8. Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
9. Department of Radiotherapy, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
10. Institute for Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
11. Division of Clinical Neurooncology, Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany. Martin.Glas@uk-essen.de.
12. DKFZ-Division Translational Neurooncology at the West German Cancer Centre (WTZ), German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany. Martin.Glas@uk-essen.de.
13. West German Cancer Centre (WTZ), University Hospital Essen, University Duisburg-Essen, Essen, Germany. Martin.Glas@uk-essen.de.
14. German Cancer Consortium, Partner Site University Hospital Essen, Essen, Germany. Martin.Glas@uk-essen.de.
Abstract
PURPOSE:
 
In the EF-14 trial for newly diagnosed glioblastoma (ndGBM) patients addition of Tumour Treating Fields (TTFields) to temozolomide treatment resulted in a significantly improved overall survival (OS). In the NOA-09/CeTeG trial, combination of lomustine and temozolomide was superior to temozolomide monotherapy in patients with O6-methylguanine DNA methyltransferase (MGMT) promoter methylated (MGMTm) ndGBM. We evaluated combination of these two treatment modalities in patients with MGMTm ndGBM. There have been so far no data on the combination of these two efficient regimens.
METHODS:
 
This bicentric retrospective analysis investigated 16 patients. Parameters evaluated included safety outcome as measured by Common Toxicity Criteria for Adverse Events (CTCAE), clinical outcomes, and compliance to treatment.
RESULTS:
 
Hematologic adverse events CTCAE ≥ 3 were observed in seven, hepatotoxic adverse events of CTCAE ≥ 3 in four patients. Mild to moderate skin toxicity was detected in six patients. At data cutoff, patients demonstrated a median progression-free survival (PFS) of 20 months. The usage rate of TTFields showed a high median adherence (83%) to the therapy.
CONCLUSIONS:
 
This analysis provides first indication that the combination of TTFields/lomustine/temozolomide is safe and feasible. The observed survival outcomes might suggest potential beneficial effects.
PMID: 31828428
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