Clinical outcome of an alternative fotemustine schedule in elderly patients with recurrent glioblastoma: a mono-institutional retrospective study

Giuseppe Lombardi, Luisa Bellu, Ardi Pambuku, Alessandro della Puppa, Pasquale Fiduccia, Miriam Farina, Domenico D’Avella, Vittorina Zagonel

Research output: Contribution to journalArticle

Abstract

The optimal treatment of recurrent glioblastoma (GBM) in elderly patients is unclear. Fotemustine (FTM) is a third-generation nitrosourea showing efficacy in gliomas and it has been used with different schedules in adult patients. We performed, for the first time anywhere, a mono-institutional retrospective study to analyze the clinical outcome of an alternative fotemustine schedule in elderly patients with recurrent GBM. Retrospectively, we analyzed all GBM patients 65 years or older previously treated with the combination of radiation therapy and temozolomide (TMZ), receiving an alternative FTM schedule as second-line treatment at our Oncological Center from October 2011 to October 2014 with an ECOG PS ≤ 2. FTM was administrated at 80 mg/m2 every 2 weeks for five consecutive administrations (induction phase), and then every 4 weeks at 80 mg/m2 as maintenance. We enrolled 44 patients, 33 males and 11 females; average age was 70 years. ECOG PS was 0–1 in 80 % of the patients. 38 patients relapsed during temozolomide (TMZ) therapy. MGMT methylation status was analyzed in 34 patients and MGMT was methylated in 53 % of the patients. The median progression free survival (PFS) and overall survival (OS) from FTM treatment was 4.1 months (95 % CI 3.1–5.2) and 7 months (95 % CI 5.2–8.4), respectively. Patients with MGMT methylated status and patients who relapsed after completing TMZ therapy had a longer PFS and OS from the beginning of FTM. Thrombocytopenia was the most frequent grade 3–4 haematological toxicity (9 %). The alternative schedule of FTM may be an active and safe treatment for elderly patients with recurrent glioblastoma, especially patients with methylated MGMT and who relapsed after completing temozolomide therapy.

Original languageEnglish
Pages (from-to)481-86
Number of pages6
JournalJournal of Neuro-Oncology
Volume128
Issue number3
DOIs
Publication statusPublished - Jul 2016

Keywords

  • Elderly
  • Fotemustine
  • Glioblastoma
  • Temozolomide

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neurology

Fingerprint Dive into the research topics of 'Clinical outcome of an alternative fotemustine schedule in elderly patients with recurrent glioblastoma: a mono-institutional retrospective study'. Together they form a unique fingerprint.

  • Cite this