Tamara Ius1, Daniela Cesselli2, Miriam Isola2, Giovanni Toniato3, Giada Pauletto4, Giovanni Sciacca3, Sara Fabbro2, Enrico Pegolo2, Simona Rizzato5, Antonio Paolo Beltrami2, Carla di Loreto2,6, Miran Skrap3. 1. Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy. tamara.ius@gmail.com. 2. Department of Medicine, University of Udine, Udine, Italy. 3. Neurosurgery Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy. 4. Neurology Unit, Department of Neurosciences, Santa Maria della Misericordia University Hospital, Udine, Italy. 5. Department of Oncology, Santa Maria della Misericordia University Hospital, Udine, Italy. 6. Institute of Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy.
Abstract
PURPOSE OF REVIEW: The purpose of this study was to retrospectively evaluate the use of carmustine wafers (CWs) in the management of high-grade gliomas (HGGs). The data from our monoinstitutional series was compared with studies reported in the literature. Special emphasis was placed on the evaluation of side effects and the analysis of extent of resection and molecular profile as risk factors. RECENT FINDINGS: The implantation of CWs into the resection cavity during HGG treatment to deliver localized chemotherapy, followed by the Stupp protocol, remains debated in a clinical setting, largely due to the lack of appropriate phase III studies. Given the high expense and poorly characterized side effects associated with CW treatment, identification of patients most likely to benefit from this therapy could be clinically relevant. CWs may represent an effective and safe first-line treatment for patients with HGG that exhibit complete tumor resection and harboring a methylated MGMT promoter. Our investigation showed a much larger group of patients exhibiting long-term survival (> = 36 months), strongly supporting a potential survival benefit conferred via CW treatment. The pre-surgical definition of the MGMT promoter status could be of clinical use in identifying "good responders" to CW implantation.
PURPOSE OF REVIEW: The purpose of this study was to retrospectively evaluate the use of carmustine wafers (CWs) in the management of high-grade gliomas (HGGs). The data from our monoinstitutional series was compared with studies reported in the literature. Special emphasis was placed on the evaluation of side effects and the analysis of extent of resection and molecular profile as risk factors. RECENT FINDINGS: The implantation of CWs into the resection cavity during HGG treatment to deliver localized chemotherapy, followed by the Stupp protocol, remains debated in a clinical setting, largely due to the lack of appropriate phase III studies. Given the high expense and poorly characterized side effects associated with CW treatment, identification of patients most likely to benefit from this therapy could be clinically relevant. CWs may represent an effective and safe first-line treatment for patients with HGG that exhibit complete tumor resection and harboring a methylated MGMT promoter. Our investigation showed a much larger group of patients exhibiting long-term survival (> = 36 months), strongly supporting a potential survival benefit conferred via CW treatment. The pre-surgical definition of the MGMT promoter status could be of clinical use in identifying "good responders" to CW implantation.
Authors: Linda Waldherr; Maria Seitanidou; Marie Jakešová; Verena Handl; Sophie Honeder; Marta Nowakowska; Tamara Tomin; Meysam Karami Rad; Tony Schmidt; Joachim Distl; Ruth Birner-Gruenberger; Gord von Campe; Ute Schäfer; Magnus Berggren; Beate Rinner; Martin Asslaber; Nassim Ghaffari-Tabrizi-Wizsy; Silke Patz; Daniel T Simon; Rainer Schindl Journal: Adv Mater Technol Date: 2021-04-12
Authors: Alexandra McAleenan; Claire Kelly; Francesca Spiga; Ashleigh Kernohan; Hung-Yuan Cheng; Sarah Dawson; Lena Schmidt; Tomos Robinson; Sebastian Brandner; Claire L Faulkner; Christopher Wragg; Sarah Jefferies; Amy Howell; Luke Vale; Julian P T Higgins; Kathreena M Kurian Journal: Cochrane Database Syst Rev Date: 2021-03-12