BACKGROUND: Treatment for recurrent glioblastoma is poor, and there is a need for better therapies. Here we retrospectively assessed the efficacy and toxicity of temozolomide plus apatinib, an oral small-molecule tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor 2 in recurrent glioblastoma. MATERIALS AND METHODS: A retrospective analysis of patients with recurrent glioblastoma who underwent apatinib plus temozolomide treatment was performed. Apatinib was given at 500 mg once daily. Temozolomide was administered at 200 mg/m2/d on days 1-5 or 50 mg/m2/d continuous daily according to whether they had experienced temozolomide maintenance treatment before. The main clinical data collected included tumor characteristics, status of MGMT promoter, and IDH mutation, number of relapse, response, survival, adverse reactions, and salvage therapies. RESULTS: From April 2016 to August 2019, thirty-one patients were identified. The objective response rate was 26.3%, and the disease control rate was 84.2%. The progression-free survival (PFS) at 6 months and overall survival (OS) at 12 months were 44.6 and 30.2%. The median PFS and OS were 4.9 and 8.2 months, respectively. Two patients achieved long PFS of 30.9 and 38.7+ months. The median survival time after progression of the patients with or without salvage bevacizumab was 5.1 versus 1.2 months. The most common grade 3 or 4 toxicities were hypertension (5.8%), decreased appetite (5.8%), and thrombocytopenia (4.3%), most of which were resolved after symptomatic treatment or dose reduction. CONCLUSION: Apatinib plus temozolomide is an effective salvage regimen with manageable toxicities for recurrent glioblastoma and could not reduce the sensitivity to bevacizumab.
BACKGROUND: Treatment for recurrent glioblastoma is poor, and there is a need for better therapies. Here we retrospectively assessed the efficacy and toxicity of temozolomide plus apatinib, an oral small-molecule tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor 2 in recurrent glioblastoma. MATERIALS AND METHODS: A retrospective analysis of patients with recurrent glioblastoma who underwent apatinib plus temozolomide treatment was performed. Apatinib was given at 500 mg once daily. Temozolomide was administered at 200 mg/m2/d on days 1-5 or 50 mg/m2/d continuous daily according to whether they had experienced temozolomide maintenance treatment before. The main clinical data collected included tumor characteristics, status of MGMT promoter, and IDH mutation, number of relapse, response, survival, adverse reactions, and salvage therapies. RESULTS: From April 2016 to August 2019, thirty-one patients were identified. The objective response rate was 26.3%, and the disease control rate was 84.2%. The progression-free survival (PFS) at 6 months and overall survival (OS) at 12 months were 44.6 and 30.2%. The median PFS and OS were 4.9 and 8.2 months, respectively. Two patients achieved long PFS of 30.9 and 38.7+ months. The median survival time after progression of the patients with or without salvage bevacizumab was 5.1 versus 1.2 months. The most common grade 3 or 4 toxicities were hypertension (5.8%), decreased appetite (5.8%), and thrombocytopenia (4.3%), most of which were resolved after symptomatic treatment or dose reduction. CONCLUSION: Apatinib plus temozolomide is an effective salvage regimen with manageable toxicities for recurrent glioblastoma and could not reduce the sensitivity to bevacizumab.
Authors: J Dawn Waters; Carlos Sanchez; Ayguen Sahin; Diahnn Futalan; David D Gonda; Justin K Scheer; Johnny Akers; Kamalakannan Palanichamy; Peter Waterman; Arnab Chakravarti; Ralph Weissleder; Brent Morse; Nick Marsh; Eric Furfine; Clark C Chen; Irvith Carvajal; Bob S Carter Journal: J Neurooncol Date: 2012-08-09 Impact factor: 4.130
Authors: Walter Taal; Hendrika M Oosterkamp; Annemiek M E Walenkamp; Hendrikus J Dubbink; Laurens V Beerepoot; Monique C J Hanse; Jan Buter; Aafke H Honkoop; Dolf Boerman; Filip Y F de Vos; Winand N M Dinjens; Roelien H Enting; Martin J B Taphoorn; Franchette W P J van den Berkmortel; Rob L H Jansen; Dieta Brandsma; Jacoline E C Bromberg; Irene van Heuvel; René M Vernhout; Bronno van der Holt; Martin J van den Bent Journal: Lancet Oncol Date: 2014-07-15 Impact factor: 41.316
Authors: Seunggu J Han; John D Rolston; Annette M Molinaro; Jennifer L Clarke; Michael D Prados; Susan M Chang; Mitchel S Berger; Ashley DeSilva; Nicholas A Butowski Journal: Neuro Oncol Date: 2014-03-26 Impact factor: 12.300
Authors: Michael Weller; Ghazaleh Tabatabai; Bärbel Kästner; Jörg Felsberg; Joachim P Steinbach; Antje Wick; Oliver Schnell; Peter Hau; Ulrich Herrlinger; Michael C Sabel; Hans-Georg Wirsching; Ralf Ketter; Oliver Bähr; Michael Platten; Jörg C Tonn; Uwe Schlegel; Christine Marosi; Roland Goldbrunner; Roger Stupp; Krisztian Homicsko; Josef Pichler; Guido Nikkhah; Jürgen Meixensberger; Peter Vajkoczy; Spyros Kollias; Johannes Hüsing; Guido Reifenberger; Wolfgang Wick Journal: Clin Cancer Res Date: 2015-02-05 Impact factor: 12.531
Authors: Henry S Friedman; Michael D Prados; Patrick Y Wen; Tom Mikkelsen; David Schiff; Lauren E Abrey; W K Alfred Yung; Nina Paleologos; Martin K Nicholas; Randy Jensen; James Vredenburgh; Jane Huang; Maoxia Zheng; Timothy Cloughesy Journal: J Clin Oncol Date: 2009-08-31 Impact factor: 44.544
Authors: W K Yung; R E Albright; J Olson; R Fredericks; K Fink; M D Prados; M Brada; A Spence; R J Hohl; W Shapiro; M Glantz; H Greenberg; R G Selker; N A Vick; R Rampling; H Friedman; P Phillips; J Bruner; N Yue; D Osoba; S Zaknoen; V A Levin Journal: Br J Cancer Date: 2000-09 Impact factor: 7.640