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.
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: Philip Lee; Ben Murphy; Rickey Miller; Vivek Menon; Naren L Banik; Pierre Giglio; Scott M Lindhorst; Abhay K Varma; William A Vandergrift; Sunil J Patel; Arabinda Das Journal: Anticancer Res Date: 2015-02 Impact factor: 2.480
Authors: Abdel Nasser Hosein; Yi Chieh Lim; Bryan Day; Brett Stringer; Stephen Rose; Richard Head; Leah Cosgrove; Peter Sminia; Michael Fay; Jennifer H Martin Journal: J Neurooncol Date: 2015-02-04 Impact factor: 4.130
Authors: Sung Won Kim; Jacob M Hooker; Nicola Otto; Khaing Win; Lisa Muench; Colleen Shea; Pauline Carter; Payton King; Alicia E Reid; Nora D Volkow; Joanna S Fowler Journal: Nucl Med Biol Date: 2013-07-29 Impact factor: 2.408
Authors: Johannes E A Wolff; Christof Kramm; Rolf-Dieter Kortmann; Torsten Pietsch; Stefan Rutkowski; Norbert Jorch; Astrid Gnekow; Pablo Hernáiz Driever Journal: J Neurooncol Date: 2008-08-05 Impact factor: 4.130