Nayan Lamba1,2, Malia McAvoy3, Vasileios K Kavouridis4,5, Timothy R Smith2,4, Mehdi Touat6,7,8, David A Reardon2,9, J Bryan Iorgulescu2,4,10. 1. Department of Radiation Oncology, Brigham and Women's Hospital, Boston, Massachusetts, USA. 2. Harvard Medical School, Boston, Massachusetts, USA. 3. Department of Neurological Surgery, University of Washington Medical Center, Seattle, Washington, USA. 4. Department of Neurosurgery, Computational Neuroscience Outcomes Center, Brigham and Women's Hospital, Boston, Massachusetts, USA. 5. Department of Neurosurgery, St. Olavs Hospital, Trondheim, Norway. 6. Service de Neurologie 2-Mazarin, Sorbonne Université, Inserm, CNRS, UMR S 1127, Institut du Cerveau, ICM, AP-HP, Hôpitaux Universitaires La Pitié Salpêtrière-Charles Foix, Paris, France. 7. Sorbonne Université, INSERM, Unité Mixte de Recherche Scientifique 938 and Site de Recherche Intégrée sur le Cancer (SIRIC) Cancer United Research Associating Medicine, University & Society (CURAMUS), Centre de Recherche Saint-Antoine, Equipe Instabilité des Microsatellites et Cancer, Equipe labellisée par la Ligue Nationale contre le Cancer, Paris, France. 8. Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA. 9. Department of Medical Oncology, Center for Neuro-Oncology, Dana-Farber Cancer Center, Boston, Massachusetts, USA. 10. Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Abstract
Background: The optimal chemotherapy regimen between temozolomide and procarbazine, lomustine, and vincristine (PCV) remains uncertain for WHO grade 3 oligodendroglioma (Olig3) patients. We therefore investigated this question using national data. Methods: Patients diagnosed with radiotherapy-treated 1p/19q-codeleted Olig3 between 2010 and 2018 were identified from the National Cancer Database. The overall survival (OS) associated with first-line single-agent temozolomide vs multi-agent PCV was estimated by Kaplan-Meier techniques and evaluated by multivariable Cox regression. Results: One thousand five hundred ninety-six radiotherapy-treated 1p/19q-codeleted Olig3 patients were identified: 88.6% (n = 1414) treated with temozolomide and 11.4% (n = 182) with PCV (from 5.4% in 2010 to 12.0% in 2018) in the first-line setting. The median follow-up was 35.5 months (interquartile range [IQR] 20.7-60.6 months) with 63.3% of patients alive at the time of analysis. There was a significant difference in unadjusted OS between temozolomide (5-year OS 58.9%, 95%CI: 55.6-62.0) and PCV (5-year OS 65.1%, 95%CI: 54.8-73.5; P = .04). However, a significant OS difference between temozolomide and PCV was not observed in the Cox regression analysis adjusted by age and extent of resection (PCV vs temozolomide HR 0.81, 95%CI: 0.59-1.11, P = .18). PCV was more frequently used for younger Olig3s but otherwise was not associated with patient's insurance status or care setting. Conclusions: In a national analysis of Olig3s, first-line PCV chemotherapy was associated with a slightly improved unadjusted short-term OS compared to temozolomide; but not following adjustment by patient age and extent of resection. There has been an increase in PCV utilization since 2010. These findings provide preliminary data while we await the definitive results from the CODEL trial.
Background: The optimal chemotherapy regimen between temozolomide and procarbazine, lomustine, and vincristine (PCV) remains uncertain for WHO grade 3 oligodendroglioma (Olig3) patients. We therefore investigated this question using national data. Methods: Patients diagnosed with radiotherapy-treated 1p/19q-codeleted Olig3 between 2010 and 2018 were identified from the National Cancer Database. The overall survival (OS) associated with first-line single-agent temozolomide vs multi-agent PCV was estimated by Kaplan-Meier techniques and evaluated by multivariable Cox regression. Results: One thousand five hundred ninety-six radiotherapy-treated 1p/19q-codeleted Olig3 patients were identified: 88.6% (n = 1414) treated with temozolomide and 11.4% (n = 182) with PCV (from 5.4% in 2010 to 12.0% in 2018) in the first-line setting. The median follow-up was 35.5 months (interquartile range [IQR] 20.7-60.6 months) with 63.3% of patients alive at the time of analysis. There was a significant difference in unadjusted OS between temozolomide (5-year OS 58.9%, 95%CI: 55.6-62.0) and PCV (5-year OS 65.1%, 95%CI: 54.8-73.5; P = .04). However, a significant OS difference between temozolomide and PCV was not observed in the Cox regression analysis adjusted by age and extent of resection (PCV vs temozolomide HR 0.81, 95%CI: 0.59-1.11, P = .18). PCV was more frequently used for younger Olig3s but otherwise was not associated with patient's insurance status or care setting. Conclusions: In a national analysis of Olig3s, first-line PCV chemotherapy was associated with a slightly improved unadjusted short-term OS compared to temozolomide; but not following adjustment by patient age and extent of resection. There has been an increase in PCV utilization since 2010. These findings provide preliminary data while we await the definitive results from the CODEL trial.
Authors: Michael Weller; Martin van den Bent; Jörg C Tonn; Roger Stupp; Matthias Preusser; Elizabeth Cohen-Jonathan-Moyal; Roger Henriksson; Emilie Le Rhun; Carmen Balana; Olivier Chinot; Martin Bendszus; Jaap C Reijneveld; Frederick Dhermain; Pim French; Christine Marosi; Colin Watts; Ingela Oberg; Geoffrey Pilkington; Brigitta G Baumert; Martin J B Taphoorn; Monika Hegi; Manfred Westphal; Guido Reifenberger; Riccardo Soffietti; Wolfgang Wick Journal: Lancet Oncol Date: 2017-05-05 Impact factor: 41.316
Authors: Martin J van den Bent; Alba A Brandes; Martin J B Taphoorn; Johan M Kros; Mathilde C M Kouwenhoven; Jean-Yves Delattre; Hans J J A Bernsen; Marc Frenay; Cees C Tijssen; Wolfgang Grisold; László Sipos; Roelien H Enting; Pim J French; Winand N M Dinjens; Charles J Vecht; Anouk Allgeier; Denis Lacombe; Thierry Gorlia; Khê Hoang-Xuan Journal: J Clin Oncol Date: 2012-10-15 Impact factor: 44.544
Authors: Manmeet S Ahluwalia; Hao Xie; Saurabh Dahiya; Nooshin Hashemi-Sadraei; David Schiff; Paul G Fisher; Marc C Chamberlain; Susan Pannullo; Herbert B Newton; Cathy Brewer; Laura Wood; Richard Prayson; Paul Elson; David M Peereboom Journal: J Neurooncol Date: 2014-12-23 Impact factor: 4.130
Authors: T Mikkelsen; T Doyle; J Anderson; J Margolis; N Paleologos; J Gutierrez; D Croteau; L Hasselbach; R Avedissian; L Schultz Journal: J Neurooncol Date: 2008-11-15 Impact factor: 4.130
Authors: J G Cairncross; K Ueki; M C Zlatescu; D K Lisle; D M Finkelstein; R R Hammond; J S Silver; P C Stark; D R Macdonald; Y Ino; D A Ramsay; D N Louis Journal: J Natl Cancer Inst Date: 1998-10-07 Impact factor: 13.506
Authors: J Bryan Iorgulescu; Maya Harary; Cheryl K Zogg; Keith L Ligon; David A Reardon; F Stephen Hodi; Ayal A Aizer; Timothy R Smith Journal: Cancer Immunol Res Date: 2018-07-12 Impact factor: 11.151
Authors: Kurt A Jaeckle; Karla V Ballman; Martin van den Bent; Caterina Giannini; Evanthia Galanis; Paul D Brown; Robert B Jenkins; J Gregory Cairncross; Wolfgang Wick; Michael Weller; Kenneth D Aldape; Jesse G Dixon; S Keith Anderson; Jane H Cerhan; Jeffrey S Wefel; Martin Klein; Stuart A Grossman; David Schiff; Jeffrey J Raizer; Frederick Dhermain; Donald G Nordstrom; Patrick J Flynn; Michael A Vogelbaum Journal: Neuro Oncol Date: 2021-03-25 Impact factor: 12.300