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
3336 - Survival outcome of non-small cell lung cancer (NSCLC) patients: Comparing results between the database of the Comprehensive Cancer Center Zürich (CCCZ) and the Epidemiological Cancer Registry Zurich and Zug (KKR)
Presenter: Rolf A. Stahel
Session: Poster Display session 1
Resources:
Abstract
2204 - NORA trial (GECP 15/02): Updated results of the Spanish Lung Cancer Group (SLCG) phase II trial of concurrent chemo-radiotherapy (CT-RT) with cisplatin (P) plus metronomic oral vinorelbine (mOV) for unresectable locally advanced non-small cell lung cancer (LA-NSCLC)
Presenter: María Guirado
Session: Poster Display session 1
Resources:
Abstract
1446 - A nomogram to predict outcomes of lung cancer patients after pneumonectomy based on 47 indicators set by principle component analysis
Presenter: Bo Cheng
Session: Poster Display session 1
Resources:
Abstract
1788 - Prognostic and predictive value of 18F-PET/CT on the response to treatment in locally advanced non-small cell lung cancer (NSCLC)
Presenter: Cristina Alfaro Autor
Session: Poster Display session 1
Resources:
Abstract
2299 - Comparison of three different chemotherapy regimens for concomitant chemoradiotherapy in locally advanced non small cell lung cancer
Presenter: Abdurrahman Işıkdoğan
Session: Poster Display session 1
Resources:
Abstract
4211 - Predicting the first failure pattern in patients with inoperable local advanced non-small cell lung cancer (LA-NSCLC) receiving definitive chemoradiotherapy: Establishment and internal validation of a nomogram based on the clinicopathological factors
Presenter: Xueru Zhu
Session: Poster Display session 1
Resources:
Abstract
1550 - Prognostic impact of neutrophil-to-lymphocyte ratio (NLR) pre and post chemoradiotherapy (CRT) in stage III non-small cell lung cancer (NSCLC)
Presenter: Vicente Palomar Abril
Session: Poster Display session 1
Resources:
Abstract
2345 - Meta-analysis evaluating neutropenia incidence with EGFR inhibitors and chemotherapy in patients with NSCLC
Presenter: Bernardo Rapoport
Session: Poster Display session 1
Resources:
Abstract
3747 - Effector CD4+ T-cell induction by thoracic radiotherapy for patients with NSCLC
Presenter: Yu Miura
Session: Poster Display session 1
Resources:
Abstract
3317 - Circulating tumor DNA (ctDNA) analysis in patients (pts) with non-small cell lung cancer (NSCLC) treated with telisotuzumab vedotin (teliso-v), an antibody-drug conjugate targeting c-Met
Presenter: Rebecca Heist
Session: Poster Display session 1
Resources:
Abstract