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

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

来源：Journal of Neuro-Oncology, 2013, 113(3): 397-401.

DOI：10.1007/s11060-013-1125-3

• Elderly patients
• Fotemustine
• Glioblastoma
• Safety
• Temozolomide

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/m(2) of FTM every week for 3 consecutive weeks (induction phase) and then every 3 weeks (70-100 mg/m(2)), 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.

• 出版日期2013-7