Procarbazine and high-dose tamoxifen as a second-line regimen in recurrent high-grade gliomas: A phase II study

Alba A. Brandes, Mario Ermani, Sergio Turazzi, Elvira Scelzi, Franco Berti, Pietro Amistà, Antonino Rotilio, Claudio Licata, Mario V. Fiorentino

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Abstract

Purpose: A phase II study was conducted in patients with high-grade gliomas that recurred after surgery plus radiotherapy and a first-line nitrosourea-based regimen. Our aim was to investigate the efficacy of procarbazine (PCB) combined with high-dose tamoxifen in relation to tumor control, toxicity, and time to progression (TTP). Patients and Methods: Fifty-three patients were treated with procarbazine in repeated 30-day courses at 100 mg/m2/d plus tamaxifen 100 mg/d, with a 30-day interval between courses. Thirty-four patients had been pretreated with a first-line nitrosourea-based chemotherapy regimen (group A), and 19 patients had also been pretreated with a second-line chemotherapy regimen consisting of carboplatin and teniposide (group B). Twenty-one of the patients had also been procarbazine pretreated, whereas the remaining 32 patients were not procarbazine pretreated. Results: The response was assessed in 51 patients, 28 of whom had glioblastoma multiforme (GBM) and 23 of whom had anaplastic astrocytoma (AA). There were two complete responses (CR) (4%) and 13 partial responses (PR) (25.5%). The overall response rate (CR + PR) was 29.5% (SE, 6.4; 95% confidence interval [CI], 23 to 35.8). Seventeen patients (32%) had stable disease (SE, 6.2; 95% CI, 21 to 33.6). The median TTP was 13 weeks for patients with GBM and 33 weeks for patients with AA (P = .006). The median survival time (MST) was 27 weeks for patients with GBM and 57 weeks for those with AA (P = .006). Conclusion: Combined PCB and tamoxifen as a second-line regimen gave a reasonably high response rate in patients with heavily pretreated high-grade gliomas. However, although it resulted in an improvement in the patients' quality of life and/or performance status, it was not followed by an increased TTP or MST.

Original languageEnglish
Pages (from-to)645-650
Number of pages6
JournalJournal of Clinical Oncology
Volume17
Issue number2
Publication statusPublished - Feb 1999

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ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Brandes, A. A., Ermani, M., Turazzi, S., Scelzi, E., Berti, F., Amistà, P., Rotilio, A., Licata, C., & Fiorentino, M. V. (1999). Procarbazine and high-dose tamoxifen as a second-line regimen in recurrent high-grade gliomas: A phase II study. Journal of Clinical Oncology, 17(2), 645-650.