Abstract 1382
Background
Glioblastoma (GBM) is well known as the most common primary aggressive malignant brain tumor of the CNS and became one of the most lethal forms of cancer in human. The prognosis for patients with GBM is very poor. Current treatment options for recurrent GBM are very limited. Apatinib, a novel small molecular anti-angiogenic inhibitor, can highly selectively bind VEGFR-2 and inhibit its activation to block VEGF mediated the signal transduction and inhibit the angiogenesis to control the growth of the tumors. We hypothesized that apatinib combined with dose-dense TMZ could lead to prolonged 6-month PFS and/or OS. We also assessed toxicity and tolerability.
Methods
Patients with recurrent glioblastoma were enrolled in this study. Patients were treated with concurrent treatment of apatinib (500mg qd) and dose-dense temozolomide (100 mg/m2 , 7 days on with 7 days off ) until disease progression or intolerable toxicity. The efficacy was evaluated using RANO high-grade glioma criteria. The safety was assessed via NCI-CTCAE 4.0. Survival was estimated with Kaplan-Meier curve and log-rank test.
Results
From March 2016 to January 2018, twenty eligible patients who had relapsed from the standard chemoradiotherapy regimen were enrolled in this study. 35% were female and the median ages were 50.5 years. The median KPS score before treatment was 70. Median follow-up time was 12 months. KPS scores improved in 60%(12/20) of patients after treatment. In total, there were 1 with CR, 8 with PR, 9 with SD, and 2 with PD. Three patients were still alive. The ORR was 45% (9/20) and the DCR was 90% (18/20). The median PFS for all patients were 6 months (95% confidence interval [CI]: 5.3m to 7.8m). Median OS is 9.3 months (95% CI, 8.2m–12.2m). The most common treatment-related adverse events (AEs) were hypertension (20.9%), hand-foot syndrome (16.3%), leukopenia (14.0%), The grade 3/4 adverse events included hypertension (4.7%), leukopenia (2.3%), thrombocytopenia (2.3%).
Conclusions
Apatinib combined with dose-dense temozolomide seems to be a promising therapeutic option for recurrent glioblastoma with acceptable toxicity profiles. Clinical randomized controlled trial is warranted to be designed to confirm the results.
Clinical trial identification
NCT03660761.
Editorial acknowledgement
Baoyan Liu (Shandong Medical Biotechnological Center, School of Medicine and Life Science, Shandong Academy of Medical Sciences, University of Jinan) provided assistance with manuscript editing.
Legal entity responsible for the study
Shandong Cancer Hospital.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5054 - Inhibition of Rspo-Wnt pathway Facilitates Checkpoint Blockade Therapy by anti-RSPO3 antibody (DBPR117)
Presenter: John Hsu
Session: Poster Display session 1
Resources:
Abstract
3305 - A phase I dose-escalation and expansion trial of intratumorally administered CV8102, alone and in combination with anti-PD-1 in patients with advanced solid tumors
Presenter: Jürgen Krauss
Session: Poster Display session 1
Resources:
Abstract
5353 - Phase 1/2 Study of 9-ING-41, a small molecule selective Glycogen Synthase Kinase-3 Beta (GSK-3β) Inhibitor, as a Single Agent and Combined with Chemotherapy, in Patients with Refractory Hematological Malignancies or Solid Tumors
Presenter: Benedito Carneiro
Session: Poster Display session 1
Resources:
Abstract
3946 - Trial in progress: a Phase I, open-label study of GSK1795091 administered in combination with immunotherapies in participants with advanced solid tumors (NCT03447314).
Presenter: Aaron Hansen
Session: Poster Display session 1
Resources:
Abstract
3449 - Radiographic Phenotyping to Identify Intracranial Disseminated Recurrence in Brain metastases Treated With Radiosurgery Using Contrast-enhanced MR Imaging
Presenter: CheYu Hsu
Session: Poster Display session 1
Resources:
Abstract
4553 - Association between TP53 mutations and efficacy of Osimertinib for brain metastasis from EGFR-mutant lung cancer
Presenter: Lijuan Chen
Session: Poster Display session 1
Resources:
Abstract
4942 - Response assessment of melanoma brain metastases treated by stereotactic radiotherapy or immunotherapy or both: a comparison of RECIST 1.1, RANO and iRANO criteria
Presenter: Emilie Le Rhun
Session: Poster Display session 1
Resources:
Abstract
3529 - Management of multiple brain metastases by Staged SRS focusing on utmost risk lesions
Presenter: shaoqun Li
Session: Poster Display session 1
Resources:
Abstract
5315 - Whole brain radiotherapy plus simultaneous in-field boost versus whole brain radiotherapy plus fractionated stereotactic radiotherapy for multiple brain metastases of non-small cell lung cancer
Presenter: Lu Li
Session: Poster Display session 1
Resources:
Abstract
1116 - 3D based texture analysis serving as potential diagnostic factor in discriminating primary central nervous system lymphoma from metastatic brain tumors: A preliminary study
Presenter: Wen Guo
Session: Poster Display session 1
Resources:
Abstract