Drug Boost Plus Radiotherapy Promising in Glioblastoma

NEW YORK, April 10, 2009 — Intensive treatment with a combination of lomustine, temozolomide, and radiotherapy can achieve long-term survival in patients newly diagnosed with glioblastoma, German and Swiss researchers reported in the March 10 issue of the Journal of Clinical Oncology.

"We have markedly improved survival in a subgroup of patients with glioblastoma, and see a way to further extend survival by optimizing combination chemotherapy in this group of patients," senior investigator Dr Ulrich Herrlinger told Reuters Health.

Dr Herrlinger of the University of Bonn et al studied 39 patients who underwent radiotherapy. Of these, 31 were treated with standard doses of lomustine and temozolomide. The remaining 8 patients received doses of lomustine that were 10% higher and temozolomide doses that were 50% higher.

Overall, median survival was 23.1 months; 47.4% of the patients survived for 2 years, and 18.5% survived for 4 years.

After a median follow-up of 41.5 months, this endpoint had not been reached in the intensified therapy subgroup. Four of these patients survived for at least 56 months and 2 did so with no recurrence.

The team also established that methylation of the DNA repair gene MGMT promotor was associated with a reduced mortality (relative risk, 0.43) as was intensified chemotherapy (relative risk, 0.37).

WHO grade 4 hemotoxicity was seen more often in the intensified treatment group (57%) than in those given standard chemotherapy (16%). No nonhematologic toxicities were observed.

These findings, the researchers concluded, "demonstrate an encouraging therapeutic potential but also demonstrate the toxic limitations of the dose-intensified regimen in this setting."

Source: Reuters Health Information