Although
teniposide activity in
glioma was reported as early as 1971, it is only within the last 2 to 3 years that its effectiveness in
small cell lung cancer and, most dramatically, in associated brain
metastasis, has undergone long overdue systematic investigation. The
drug appears to enjoy preferential uptake by
brain-tumor tissue compared with disease-free brain tissue. Single-agent activity of
teniposide in
astrocytomas has been widely reported but the data are difficult to interpret due to differences among studies in definition of response and response duration. Combination
therapy has focused primarily on
teniposide with nitrosoureas and, again, definition variations have made it difficult to evaluate data. Similar problems
plague trials by one group of investigators who reported that the combination of
teniposide with
doxorubicin and
lomustine resulted in regression or improvement in significant percentages of their patients. While many studies indicate that
teniposide has significant potential in treatment of adult
glioma, controlled trials are needed to evaluate and optimize the use of this agent.