424P - Can time from last chemotherapy to recurrence be a predictor of chemosensitivity in recurrent globlastoma?

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Anticancer Agents
Central Nervous System Malignancies
Therapy
Biological Therapy
Presenter Enrico Franceschi
Authors E. Franceschi1, R. Agati2, R. Poggi3, P. Dall'Occa4, M. Bartolotti4, M. Di Battista4, G. Marucci5, F. Girardi3, M. Ermani6, A. Brandes7
  • 1Dept. Medical Oncology, Bellaria and Maggiore Hospitals, Azienda USL Bologna, Bologna/IT
  • 2Neuroradiology Department, Bellaria-Maggiore Hospital, Azienda USL, Bologna/IT
  • 3Medical Oncology, Bellaria-Maggiore Hospital, Azienda USL, Bologna/IT
  • 4Department Of Medical Oncology, Bellaria and Maggiore Hospitals, Azienda USL Bologna, Bologna/IT
  • 5Section Of Pathology M. Malpighi, Department Of Haematology And Oncological Sciences L. And A. Seragnoli, Bellaria Hospital, University of Bologna, Bologna/IT
  • 6Department Of Neurosciences, Statistic And Informatic Unit, Azienda Ospedale-Università, Padova/IT
  • 7Dept. Medical Oncology, Bellaria-Maggiore Hospital, Azienda USL, Bologna/IT

Abstract

Purpose

Since temozolomide in combination with radiotherapy (RT/TMZ) became a new standard for newly diagnosed glioblastoma, the scenario at recurrence became less defined. Moreover, the role of prognostic and predictive factors for the second treatment has not been clarified.

Methods

A retrospective analysis was made for glioblastoma patients followed between 01/2005 and 06/2010. Eligibility criteria for the study were: age ≥18 years; PS:0-2; chemotherapy at disease progression after RT/TMZ, availability of data regarding second progression.

Results

232 patients with recurrent glioblastoma (mean age: 52 years, range: 18-77years, MGMT methylated/unmethylated: 62 [37.6%] / 103 [62.4%]) were evaluated. At progression after RT/TMZ, 102 patients (44%) were treated with surgery followed by chemotherapy, and 130 patients (56%) with chemotherapy alone. Chemotherapy consisted in TMZ rechallenge 5/28 in 80 patients (34%), nitrosoureas in 120 patients (52%), experimental treatments in 32 patients (14%). PFS-6 calculated from 1st to 2nd PD was 22% (95%CI:16.3-26.9%). Time from the last adjuvant TMZ treatment to recurrence (TTR) was shorter in patients treated with nitrosoureas (2.6 months) than in patients treated with TMZ (9.8 months, p < 0.00001). Univariate analysis showed that longer TTR (p = 0.007) and type of chemotherapy (TMZ vs nitrosoureas p = 0.033) were both significantly correlated with PFS. Only TTR showed an effect on PFS (p = 0.07) in multivariate analysis. Median OS from recurrence was 8.6 months (95%CI:7.4-9.8), and 11.3 months (95%CI:9.5-13), 7.4 months (95%CI:6.3-8.5), and 7.1 months (95%CI:4.6-9.8), with TMZ, nitrosoureas, or other treatments, respectively. TTR and type of chemotherapy at recurrence were significantly correlated with OS (p = 0.026 and p = 0.016) in univariate but not in multivariate analysis.

Conclusions

As in other cancer types (i.e. ovarian cancer), TTR seems to be promising as a predictive factor for PFS obtained with treatments for recurrence and could be useful in patients' stratification. TMZ rechallenge seems more useful than nitrosoureas if TTR is longer.

Disclosure

All authors have declared no conflicts of interest.