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[ASCO 2014] Neuro-Oncologia
Apoio:
A equipe do MOC selecionou os abstracts de maior impacto da ASCO 2014. Veja abaixo os destaques em Neuro-oncologia:
Neuro-oncologia
- MGMT promoter methylation as a prognostic biomarker for benefit from dose-intensified temozolomide rechallenge in progressive glioblastoma: First results from the randomized phase II DIRECTOR trial
- A multicenter randomized study comparing temozolomide (TMZ) versus TMZ-plus-bevacizumab (BEV) before standard treatment in unresectable glioblastoma (GBM) patients (p): The GENOM 009 study by the GEINO group
- Phase III study of radiation therapy (RT) with or without procarbazine, CCNU, and vincristine (PCV) in low-grade glioma: RTOG 9802 with Alliance, ECOG, and SWOG
Neuro-oncologia
MGMT promoter methylation as a prognostic biomarker for benefit from dose-intensified temozolomide rechallenge in progressive glioblastoma: First results from the randomized phase II DIRECTOR trial
Abstract No: 2015
Type: Poster Highlights Session
Time 1: Friday May 30, 1:00 PM to 4:00 PM
Location 1: E354b
Glioblastoma patients at first progression after TMZ/RT→TMZ and at least 2 maintenance TMZ cycles were randomized to Arm A (one week on (150 mg/sqm TMZ per day) / one week off) or to Arm B (three weeks on (100 mg/sqm TMZ per day) / one week off). The primary end point was median time to treatment failure defined as progression, premature (< 12 months) TMZ discontinuation for toxicity, or death from any cause; 166 patients were deemed necessary to show a meaningful difference between arms. Conclusions: TMZ rechallenge is an active treatment for MGMT promoter-methylated glioblastoma progressive after standard therapy. The best TMZ regimen remains to be defined. Alternative strategies are warranted for patients with progressive MGMT-unmethylated glioblastoma. Clinical trial information: NCT00941460.
A multicenter randomized study comparing temozolomide (TMZ) versus TMZ-plus-bevacizumab (BEV) before standard treatment in unresectable glioblastoma (GBM) patients (p): The GENOM 009 study by the GEINO group
Meeting: 2014 ASCO Annual Meeting
Abstract No: 2028
Session: Central Nervous System Tumors
Type: Poster Highlights Session
Time 1: Friday May 30, 1:00 PM to 4:00 PM
Location 1: E354b
Author(s): Carmen Balana, Ramon De Las Penas, Juan Manuel Sepúlveda, et al.
Between December 2009 and April 2013, p with unresectable GBM, PS<3 and MMS ≥25 were randomly assigned to receive eitherTMZ (85 mg/m², days 1–21, for 2, 28-day cycles), followed by standard TMZ with concomitant radiotherapy (60Gy) and then adjuvant TMZ for 6 cycles (TMZ Arm), or the same regimen but with the addition of BEV (10mg/kg /15 days) during pre-radiotherapy and concomitant treatment (BEV Arm). The primary endpoint was response according to RANO criteria after the 2 pre-radiotherapy cycles.The study was powered to detect a 30% difference between arms (α and β errors of 0.05 and 0.20). Secondary endpoints included toxicity, neurological deterioration before radiation, progression-free survival (PFS), overall survival (OS) and 1-year survival. Conclusions: The primary endpoint was met. The response rate was significantly higher in the BEV Arm. A tendency towards improved PFS, OS and 1-year survival was also observed in the BEV Arm, but the trial was not powered to detect statistical significance for these outcomes.TMZ+BEV is a feasible and effective option for unresectable GBM p. Clinical trial information: NCT01102595.
Phase III study of radiation therapy (RT) with or without procarbazine, CCNU, and vincristine (PCV) in low-grade glioma: RTOG 9802 with Alliance, ECOG, and SWOG
Abstract No: 2000
Type: Oral Abstract Session
Time: Sunday June 1, 8:00 AM to 11:00 AM
Location: E450
Author(s): Jan C. Buckner, Stephanie L. Pugh, Edward G. Shaw, et al.
Eligibility criteria included age <40 years with subtotal resection or biopsy, age >40 with any extent of resection, and supratentorial grade II astrocytoma (A), oligo-astrocytoma (OA), or oligodendroglioma (O). Patients were stratified by age, histology, Karnofsky Performance Status, and presence versus absence of contrast enhancement on the preoperative imaging study and randomized to RT alone (54 Gy in 30 fractions) or RT followed by 6 cycles of PCV chemotherapy. Wilcoxon test was used to compare survival distributions. Cox proportional hazard models were used to identify prognostic variables. Conclusions: For grade 2 glioma patients with less than gross total tumor resection or >40 years of age, PCV + RT prolongs both OS and PFS compared with RT alone. Patients with A or A-dominant OA have worse outcomes, as do males. Multivariable models that incorporate 1p/19q co-deletion and IDH mutational analyses may more fully elucidate the magnitude of treatment benefit for patients with tumors identified by specific histologic type and molecular markers. Clinical trial information: NCT00003375.