Influence of valproic acid on outcome of high-grade gliomas in children.

Abstract

BACKGROUND:

Chemotherapy has limited effects in the treatment of high-grade gliomas (HGGs). Valproic acid (VPA), a histone deacetylase (HDAC) inhibitor, may sensitize HGGs to radiochemotherapy. As the drug has been given frequently as an antiepileptic drug, a retrospective analysis was conducted to ensure relevant information was not missed before a prospective study was launched.

MATERIALS AND METHODS:

An analysis of 66 pediatric patients (range, 1-19 years of age) with glioblastoma multiforme (GBM) (n=40) or anaplastic astrocytoma (AA) (n=26) was retrospectively conducted for predictors of survival and response and for effects of VPA on outcome or toxicity.

RESULTS:

The overall survival (OS) was better for AA (p=0.0114) and complete resection (p<0.00005) and event-free survival (EFS) was better for complete resection (p=0.0049). Nine patients received VPA (for seizure) plus further oncological treatment. The most severe adverse effect was a pulmonary embolism (n=1); no other severe side-effects were noted. The response to nonsurgical treatment after 8 weeks was: complete response (CR): 0, partial response (PR): 3, stable disease (SD): 4, progressive disease (PD): 2. Some of the patients with SD responded later resulting in best response: CR:0, PR:5, SD:2, PD:2.

CONCLUSION:

Treatment with VPA plus radiochemotherapy is well tolerated with an encouraging response rate.

• Authors: Amirhadi Masoudi, Marily Elopre, Elham Amini, Margaret E Nagel, Joann L Ater, Vidya Gopalakrishnan, Johannes E A Wolff
• Journal: Anticancer research (Anticancer Res) 2008 Jul-Aug Vol. 28 Issue 4C Pg. 2437-42 ISSN: 0250-7005 [Print] Greece
• PMID: 18751431 (Publication Type: Journal Article)

Chemical References

• Valproic Acid

Topics

• Adolescent
• Adult
• Astrocytoma (drug therapy, surgery)
• Child
• Child, Preschool
• Disease-Free Survival
• Female
• Glioblastoma (drug therapy, surgery)
• Humans
• Infant
• Male
• Retrospective Studies
• Valproic Acid (adverse effects, therapeutic use)