Temozolomide for recurrent intracranial supratentorial platinum-refractory ependymoma.

Abstract

BACKGROUND:

To the authors' knowledge, there currently is no standard therapy for platinum-resistant ependymoma; hence, a need exists for new therapies. In the current study, a retrospective evaluation of temozolomide (TMZ) in adults with recurrent, supratentorial, platinum-refractory, World Health Organization grade 2 ependymoma was performed, with an objective of determining 6-month progression-free survival (PFS).

METHODS:

A total of 25 patients, ages 28 to 63 years, with recurrent ependymoma were treated. All patients had previously been treated with surgery, radiotherapy, and platinum-based chemotherapy (cisplatin in 15 patients and carboplatin in 10 patients). Nine patients underwent repeat surgery. Patients were treated at the time of second recurrence with TMZ (5 consecutive days), once every 4 weeks, which was defined as a single cycle. Neurologic evaluation was performed every 4 weeks and neuroradiographic assessment every 8 weeks.

RESULTS:

A total of 68 cycles of TMZ (median, 2 cycles; range, 1-6 cycles) was administered. TMZ-related toxicity included leukopenia (7 patients; 1 with grade 3 [grade was determine according to National Cancer Institute Common Toxicity Criteria [version 3.0]), constipation (6 patients; none with grade 3), fatigue (5 patients; none with grade 3), anemia (2; none with grade 3), thrombocytopenia (2; none with grade 3), and deep vein thrombosis (2; none with grade 3). One patient (4%) demonstrated a partial radiographic response, 9 (36%) had stable disease, and 15 (60%) developed progressive disease after 2 cycles of TMZ. Time to tumor progression ranged from 1 to 7 months (median, 2 months). Survival ranged from 2 to 8 months (median, 3 months). The 6-month and 12-month PFS were 2% and 0%, respectively.

CONCLUSIONS:

TMZ in this dose schedule demonstrated little efficacy in a cohort of adults with recurrent, intracranial, platinum-refractory ependymoma.

• Authors: Marc C Chamberlain, Sandra K Johnston
• Journal: Cancer (Cancer) Vol. 115 Issue 20 Pg. 4775-82 (Oct 15 2009) ISSN: 0008-543X [Print] United States
• PMID: 19569246 (Publication Type: Journal Article)
• Copyright: Copyright (c) 2009 American Cancer Society.

Chemical References

• Antineoplastic Agents, Alkylating
• Ferrous Compounds
• Metallocenes
• EX 10-478
• Dacarbazine
• Carboplatin
• Cisplatin
• Temozolomide

Topics

• Adult
• Antineoplastic Agents, Alkylating (therapeutic use)
• Carboplatin (therapeutic use)
• Cisplatin (therapeutic use)
• Dacarbazine (adverse effects, analogs & derivatives, therapeutic use)
• Disease-Free Survival
• Drug Resistance, Neoplasm
• Ependymoma (drug therapy)
• Female
• Ferrous Compounds
• Humans
• Male
• Metallocenes
• Middle Aged
• Neoplasm Recurrence, Local
• Retreatment
• Supratentorial Neoplasms (drug therapy)
• Temozolomide