1659P - Inhibitors of proteolysis in cerebrospinal fluid of patients with malignant gliomas after two types of local intraoperative chemotherapy

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Central Nervous System Malignancies
Surgery and/or Radiotherapy of Cancer
Presenter Larisa Kozlova
Citation Annals of Oncology (2014) 25 (suppl_4): iv564-iv573. 10.1093/annonc/mdu359
Authors L. Kozlova1, E. Frantsiyants1, D. Atmachidi2, T. Gorbunova3
  • 1Laboratory Of Pathogenesis Of Malignant Tumors, Rostov Research Oncological Institute, 344037 - Rostov-on-Don/RU
  • 2Department Of Tumors Of Cns, Rostov Research Oncological Institute, 344037 - Rostov-on-Don/RU
  • 3Outpatient Department, Rostov Research Oncological Institute, 344037 - Rostov-on-Don/RU

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Abstract

Aim

Endogenous inhibitors (EI), being acute phase proteins, can give information on effectiveness of local intraoperative chemotherapy (LICT).

Methods

α-2-Macroglobulin (α-2M) and α-1-proteinase inhibitor (α-1PI) were defined in cerebrospinal fluid (CF) of patients with malignant gliomas (MG) (28 men, 14 women, Т2-3NхMo) before LICT and in postoperative period (p/o). LICT-1: carboplatin 0.2 mg was put in a container of haemostatic sponge, and after hemostasis was secured, it was placed in tumor bed (22 patients); LICT-2: 0.4 mg cisplatin and 15 mg methotrexate were introduced in the tumor bed through the Ommaya Reservoir, and repeated twice with 1 month intervals (20 patients). EI were detected by the ELISA method using standard test kits. CF of 9 patients without inflammatory or malignant processes in brain served as control (CCF).

Results

On the 7th day (7d) after LICT-1 (a/LICT-1) and LICT-2 α-2M in all patients was higher than CCF (р<0.01) but lower (р<0.01) than the data before the treatment (background). In groups with unfavorable p/o (-p/o) α-2М was lower than that in groups with favorable p/o (+p/o, р<0,01 in all the cases) in both types of LICT. One month (1m) a/LICT-2 α-2M was significantly lower (р<0.01) than that a/LICT-1, and 2m a/LICT-1 continued tumor growth with lethal outcome was observed in 23% of the cases, while α-2М activity maintained at the same level in the others. α-2М in CF 2m a/LICT-2 decreased in comparison with the previous period and background (р<0.1 in all the cases) being still higher than CCF, with no lethal outcomes. EI α-1PI a/LICT-1 on 7d was higher than CCF and background (р<0.01) in patients with –p/o and exceeded the index of the group with +p/o where it decreased in comparison with background still being higher than CCF (р<0.01). In 1m α-1PI was equal to CCF in survived patients. In +p/o a/LICT-2 decrease of α-1PI was observed on 7d (р<0.01) with its increase in 1m (р<0.01) and retention of activity in 2m. In groups with –p/o on 7d a/LICT-1 and a/LICT-2 α-1PI was higher than in groups with +p/o, background and CCF (р<0.01 in all cases).

Conclusions

Moderate activation of EI in treatment of MG and their stabilization stimulate endogenous protection in both types of therapy, but LICT-2 appeared to be more adequate.

Disclosure

All authors have declared no conflicts of interest.