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Phase II Trial of Upfront Bevacizumab, Irinotecan, and Temozolomide for Unresectable Glioblastoma.

Publication ,  Journal Article
Peters, KB; Lou, E; Desjardins, A; Reardon, DA; Lipp, ES; Miller, E; Herndon, JE; McSherry, F; Friedman, HS; Vredenburgh, JJ
Published in: Oncologist
July 2015

LESSONS LEARNED: Trials focusing on unresectable multifocal glioblastoma are needed because of the extremely poor prognosis and challenges in receiving standard therapy, such as concurrent radiation and chemotherapy.Developing a strategy to chemically debulk tumors before radiation and/or surgery is warranted. BACKGROUND: Extent of resection remains a key prognostic factor in glioblastoma (GBM), with gross total resection providing a better prognosis than biopsy or subtotal resection. We conducted a phase II trial of upfront therapy with bevacizumab (BV), irinotecan (CPT-11), and temozolomide (TMZ) prior to chemoradiation in patients with unresectable, subtotally resected, and/or multifocal GBM. METHODS: Patients received up to 4 cycles of TMZ at 200 mg/m(2) per day on days 1-5 (standard dosing) and BV at 10 mg/kg every 2 weeks on a 28-day cycle. CPT-11 was given every 2 weeks on a 28-day cycle at 125 mg/m(2) or 340 mg/m(2) depending on antiepileptic drugs. Magnetic resonance imaging of the brain was done every 4 weeks, and treatment continued as long as there was no tumor progression or unmanageable toxicity. The primary endpoint was tumor response rate, with a goal of 26% or greater. RESULTS: Forty-one patients were enrolled from December 2009 to November 2010. Radiographic responses were as follows: 9 patients (22.0%) had partial response, 25 (61.0%) had stable disease, and 2 (4.9%) had progression; 5 patients were not assessed. Cumulative response rate was 22%. Median overall survival was 12 months (95% confidence interval: 7.2-13.5 months). CONCLUSION: Upfront treatment with BV, TMZ, and CPT-11 is tolerable and can lead to radiographic response in unresectable and/or subtotally resected GBM.

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Published In

Oncologist

DOI

EISSN

1549-490X

Publication Date

July 2015

Volume

20

Issue

7

Start / End Page

727 / 728

Location

England

Related Subject Headings

  • Treatment Outcome
  • Temozolomide
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Irinotecan
  • Humans
  • Glioblastoma
  • Female
  • Drug Administration Schedule
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Peters, K. B., Lou, E., Desjardins, A., Reardon, D. A., Lipp, E. S., Miller, E., … Vredenburgh, J. J. (2015). Phase II Trial of Upfront Bevacizumab, Irinotecan, and Temozolomide for Unresectable Glioblastoma. Oncologist, 20(7), 727–728. https://doi.org/10.1634/theoncologist.2015-0135
Peters, Katherine B., Emil Lou, Annick Desjardins, David A. Reardon, Eric S. Lipp, Elizabeth Miller, James E. Herndon, Frances McSherry, Henry S. Friedman, and James J. Vredenburgh. “Phase II Trial of Upfront Bevacizumab, Irinotecan, and Temozolomide for Unresectable Glioblastoma.Oncologist 20, no. 7 (July 2015): 727–28. https://doi.org/10.1634/theoncologist.2015-0135.
Peters KB, Lou E, Desjardins A, Reardon DA, Lipp ES, Miller E, et al. Phase II Trial of Upfront Bevacizumab, Irinotecan, and Temozolomide for Unresectable Glioblastoma. Oncologist. 2015 Jul;20(7):727–8.
Peters, Katherine B., et al. “Phase II Trial of Upfront Bevacizumab, Irinotecan, and Temozolomide for Unresectable Glioblastoma.Oncologist, vol. 20, no. 7, July 2015, pp. 727–28. Pubmed, doi:10.1634/theoncologist.2015-0135.
Peters KB, Lou E, Desjardins A, Reardon DA, Lipp ES, Miller E, Herndon JE, McSherry F, Friedman HS, Vredenburgh JJ. Phase II Trial of Upfront Bevacizumab, Irinotecan, and Temozolomide for Unresectable Glioblastoma. Oncologist. 2015 Jul;20(7):727–728.

Published In

Oncologist

DOI

EISSN

1549-490X

Publication Date

July 2015

Volume

20

Issue

7

Start / End Page

727 / 728

Location

England

Related Subject Headings

  • Treatment Outcome
  • Temozolomide
  • Oncology & Carcinogenesis
  • Middle Aged
  • Male
  • Irinotecan
  • Humans
  • Glioblastoma
  • Female
  • Drug Administration Schedule