BMC Cancer (Sep 2009)

RNOP-09: Pegylated liposomal doxorubicine and prolonged temozolomide in addition to radiotherapy in newly diagnosed glioblastoma - a phase II study

  • Proescholdt Martin,
  • Pietsch Torsten,
  • Kölbl Oliver,
  • Jauch-Worley Tanja,
  • Dietmaier Christopher,
  • Brawanski Alexander,
  • Hirschmann Birgit,
  • Steinbrecher Andreas,
  • Grauer Oliver,
  • Beier Dagmar,
  • Kleinletzenberger Christine,
  • Gorlia Thierry,
  • Schmid Christina,
  • Beier Christoph P,
  • Rümmele Petra,
  • Muigg Armin,
  • Stockhammer Günther,
  • Hegi Monika,
  • Bogdahn Ulrich,
  • Hau Peter

DOI
https://doi.org/10.1186/1471-2407-9-308
Journal volume & issue
Vol. 9, no. 1
p. 308

Abstract

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Abstract Background Although Temozolomide is effective against glioblastoma, the prognosis remains dismal and new regimens with synergistic activity are sought for. Methods In this phase-I/II trial, pegylated liposomal doxorubicin (Caelyx™, PEG-Dox) and prolonged administration of Temozolomide in addition to radiotherapy was investigated in 63 patients with newly diagnosed glioblastoma. In phase-I, PEG-Dox was administered in a 3-by-3 dose-escalation regimen. In phase-II, 20 mg/m2 PEG-Dox was given once prior to radiotherapy and on days 1 and 15 of each 28-day cycle starting 4 weeks after radiotherapy. Temozolomide was given in a dose of 75 mg/m2 daily during radiotherapy (60 Gy) and 150-200 mg/m2 on days 1-5 of each 28-day cycle for 12 cycles or until disease progression. Results The toxicity of the combination of PEG-Dox, prolonged administration of Temozolomide, and radiotherapy was tolerable. The progression free survival after 12 months (PFS-12) was 30.2%, the median overall survival was 17.6 months in all patients including the ones from Phase-I. None of the endpoints differed significantly from the EORTC26981/NCIC-CE.3 data in a post-hoc statistical comparison. Conclusion Together, the investigated combination is tolerable and feasible. Neither the addition of PEG-Dox nor the prolonged administration of Temozolomide resulted in a meaningful improvement of the patient's outcome as compared to the EORTC26981/NCIC-CE.3 data Trial registration clinicaltrials.gov NCT00944801.