Efficacy and safety of second-line fotemustine in elderly patients with recurrent glioblastoma

Matteo Santoni, Silvia Scoccianti, Ivan Lolli, Maria Grazia Fabrini, Giovanni Silvano, Beatrice Detti, Franco Perrone, Giuseppina Savio, Roberto Iacovelli, Luciano Burattini, Rossana Berardi, Stefano Cascinu

Research output: Contribution to journalArticlepeer-review


Fotemustine (FTM) is a common treatment option for glioblastoma patients refractory to temozolomide (TMZ). Although elderly patients represent a large component of glioblastoma population, the feasibility and the efficacy of second-line FTM are not available in those patients.We retrospectively analyzed the records of glioblastoma patients older than 65 years, receiving FTM at a dose of 70-100 mg/m2 of FTM every week for 3 consecutive weeks (induction phase) and then every 3 weeks (70-100 mg/m2), as second-line treatment.Between January 2004 and December 2011, 65 glioblastoma patients (median age, 70 years; range, 65-79 years) were eligible for this analysis. Sixty-five patients received a total of 364 FTM cycles, with a median of 4 cycles for each patient. After induction, we observed 1 complete response (1.5 %), 12 partial responses (18.5 %), 18 stable diseases (27.7 %), and 34 patients' progressions (47.7 %). Disease control rate was 43.1 %. Median survival from the beginning of FTM therapy was 7.1 months, while the median progression-free survival was 4.2 months, and the 6-months progression free survival rate was 35.4 %. The most relevant grade 3-4 toxicity events were thrombocytopenia (15.3 %) and neutropenia (9.2 %). In the univariate and multivariate analysis, time from radiotherapy to FTM, number of TMZ and FTM cycles and disease control resulted independent prognostic factors.This study showed that FTM is a valuable therapeutic option for elderly glioblastoma patients, with a safe toxicity profile.

Original languageEnglish
Pages (from-to)397-401
Number of pages5
JournalJournal of Neuro-Oncology
Issue number3
Publication statusPublished - Jul 2013


  • Elderly patients
  • Fotemustine
  • Glioblastoma
  • Safety
  • Temozolomide

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neurology
  • Medicine(all)


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