Emeline Tabouret1, German Reyes-Botero2, Caroline Dehais2, Marine Daros3, Maryline Barrie4, Mona Matta4, Gregorio Petrirena2, Didier Autran4, Alberto Duran2, Celine Bequet4, Jean-Yves Delattre2, Olivier Chinot4. 1. Department of Neuro-Oncology, Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille (APHM), Timone Hospital, Marseille, France emeline.tabouret@gmail.com. 2. Department of Neuro-Oncology, Assistance Publique-Hôpitaux de Paris (APHP), Pitié-Salpétrière Hospital, Paris, France. 3. Department of Neuro-Oncology, Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille (APHM), Timone Hospital, Marseille, France Department of Pharmacology, Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille (APHM), Timone Hospital, Marseille, France. 4. Department of Neuro-Oncology, Aix-Marseille University, Assistance Publique-Hôpitaux de Marseille (APHM), Timone Hospital, Marseille, France.
Abstract
BACKGROUND/AIM: The drug combination of procarbazine, lomustine (CCNU) and vincristine (PCV) has been associated with efficacy in oligodendroglial gliomas (OG) when added to radiotherapy as the first line of treatment, despite the important toxicity of this treatment schedule. The aim of the present study was to analyze the tolerance, feasibility and impact of the dose intensity of the PCV regimen on outcome for patients with OG. PATIENTS AND METHODS: We retrospectively reviewed all patients with OG receiving PCV (CCNU=110 mg/m(2)) who were referred to our two Institutions. The total dose and dose adaptation, cycle delay, dose intensity, toxicity and discontinuation of CCNU were analyzed. Impacts on the outcome were evaluated. RESULTS: Between 2007 and 2011, 89 patients received PCV. PCV was administered at relapse in 73% of patients. Only 37% completed six cycles, 13.4% discontinued PCV because of toxicity, the other patients discontinued due to tumor progression. Cycle delay and dose reduction were observed for 62% and 70% patients, respectively. Grade 3 and 4 toxicities were observed in 38% and 8% patients, respectively. Among patients whose disease did not progress under the PCV regimen, discontinuation due to toxicity was significantly correlated to poor progression-free survival (PFS: p=0.023, hazard ratio=2.354) and poor overall survival (OS: p=0.021, hazard ratio=5.093). A factor that negatively impacted PFS was the absence of CCNU dose adaptation (p=0.001), while OS was negatively impacted by the absence of cycle delay (p=0.049) and grade 3/4 toxicities (p=0.045). CONCLUSION: Despite the efficacy of the PCV regimen, significant toxicity is associated with this schedule, which appears to impact its feasibility and efficacy. The optimal PCV schedule with the appropriate CCNU dose-intensity adaptation should be redefined taking into account this finding. Copyright
BACKGROUND/AIM: The drug combination of procarbazine, lomustine (CCNU) and vincristine (PCV) has been associated with efficacy in oligodendroglial gliomas (OG) when added to radiotherapy as the first line of treatment, despite the important toxicity of this treatment schedule. The aim of the present study was to analyze the tolerance, feasibility and impact of the dose intensity of the PCV regimen on outcome for patients with OG. PATIENTS AND METHODS: We retrospectively reviewed all patients with OG receiving PCV (CCNU=110 mg/m(2)) who were referred to our two Institutions. The total dose and dose adaptation, cycle delay, dose intensity, toxicity and discontinuation of CCNU were analyzed. Impacts on the outcome were evaluated. RESULTS: Between 2007 and 2011, 89 patients received PCV. PCV was administered at relapse in 73% of patients. Only 37% completed six cycles, 13.4% discontinued PCV because of toxicity, the other patients discontinued due to tumor progression. Cycle delay and dose reduction were observed for 62% and 70% patients, respectively. Grade 3 and 4 toxicities were observed in 38% and 8% patients, respectively. Among patients whose disease did not progress under the PCV regimen, discontinuation due to toxicity was significantly correlated to poor progression-free survival (PFS: p=0.023, hazard ratio=2.354) and poor overall survival (OS: p=0.021, hazard ratio=5.093). A factor that negatively impacted PFS was the absence of CCNU dose adaptation (p=0.001), while OS was negatively impacted by the absence of cycle delay (p=0.049) and grade 3/4 toxicities (p=0.045). CONCLUSION: Despite the efficacy of the PCV regimen, significant toxicity is associated with this schedule, which appears to impact its feasibility and efficacy. The optimal PCV schedule with the appropriate CCNU dose-intensity adaptation should be redefined taking into account this finding. Copyright
Authors: Susan G R McDuff; Jorg Dietrich; Katelyn M Atkins; Kevin S Oh; Jay S Loeffler; Helen A Shih Journal: Cancer Med Date: 2019-11-07 Impact factor: 4.452
Authors: Stephen Ahn; Young Il Kim; Ja Young Shin; Jae-Sung Park; Changyoung Yoo; Youn Soo Lee; Yong-Kil Hong; Sin-Soo Jeun; Seung Ho Yang Journal: Oncol Lett Date: 2022-02-09 Impact factor: 2.967