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Terça-feira, 23.06.15

Continuous low dose temozolamide with or without VT-122 in glioblastoma.

Continuous low dose temozolamide with or without VT-122 in glioblastoma.

 

Category: 
Central Nervous System Tumors
Session Type and Session Title: 
This abstract will not be presented at the 2015 ASCO Annual Meeting but has been published in conjunction with the meeting.
Abstract Number: 

e13010

Citation: 
J Clin Oncol 33, 2015 (suppl; abstr e13010)
Author(s): 
Tanweer Shahid, Gouri Shankar Bhattacharyya, Hemant Malhotra, Kanaka Setty Govindbabu, Purvish M. Parikh, Anantbhushan Ranade, Ghanashyam Biswas, Shailesh Arjun Bondarde, Amitabha Chanda, Newell F. Bascomb; AMRI Hospital, Kolkata, India; Orchid Nursing Home, Kolkata, India; Birla Cancer Center, SMS Medical College Hospital, Jaipur, India; Kidwai Memorial Institute of Oncology, Bangalore, India; Indian Cancer Society and ICON ARO, Mumbai, India; Seth Ramdas Shah Memorial Hospital, Pune, India; Sparsh Hospital and Critical Care, Bhubaneshwar, India; Shatabdi Super Specialty Hospital, Nashik, India; Neuro Surgery, Fortis Hospital, EM Bypass Road,, Kolkata, West Bengal, India; Vicus Therapeutics, Morristown, NJ

Abstract Disclosures

Abstract: 

Background: Recurrent Glioblastoma is associated with poor prognosis despite treatment.Treatment options are limited. One of the novel methods of delivering Temozolomide is to use metronomic dosing which also has anti angiogenic properties, beside cytotoxic properties. Preclinical and clinical studies of beta-blockers and NSAIDs.Propranolol and etodolac (PE) are well known drugs that function by blocking adrenergic and prostaglandin signaling pathways.Their ability to inhibit cancer progression and metastasis may be through Anti-angiogenesis by inhibiting the expression of HIF-1alpha,iNOS and reducing cytokine—driven induction of immune regulating indoleamine 2,3 dioxygenase (IDO).Propranolol and etodolac induce changes in tumor microenvironment and immune system.The aim of this study was to evaluate the impact of the co-administration of the beta blocker Propranolol (P) and the selective COX-2 inhibitor Etodolac (E) on survival of patients with Recurrent Glioblastoma receiving Continuous low dose Temozolomide in metronomic dosing Methods: Eligible patients who had radio-chemotherapy with or without surgery for glioblastoma. All patients were treated with Temozolomide 20mg in empty stomach twice a day continuously. Patients were randomized to VT-122. All patients continued on standard planned supportive care. Patient who had received Temozolomide were continued either till progression or unacceptable toxicity. Results: 41 patients - 24 men and 16 women with proven advanced Recurrent Glioblastoma. Conclusions: Metronomic dosing of Temozolomide with VT-122 is an effective option in treatment of recurrent glioblastoma. The median survival time is almost doubled. Side-effects are manageable.

 Metrionomic
Temozolomide
(n=20)
Metrionomic
Temozolomide
and VT-122 (n=21)
Median Karnofsky Score >60 >60
Response Rate 7 (35%) 12 (57%)
Complete Response 1 (5%) 5 (24%)
Partial Response 4 (20%) 7 (33%)
Stable Disease 3 (15%) 3 (14%)
1 year survival rate 6 (30)% 14 (67%)
Median Overall Survival 9.2 months 17.6 months
Thrombocytopenia Grade III/IV 3 (15%) 5 (24%)
Neutropenia Grade III/IV 1 (5%) 2 (10%)
Anemia Grade III/IV 3 (15%) 6 (29%)

 

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por cyto às 16:50



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