Skip to main content
Log in

Phase II study of weekly carboplatin in pretreated adult malignant gliomas

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

A Correction to this article was published on 09 September 2019

This article has been updated

Abstract

Purpose

Patients with relapse of recurrent glioma have a poor outcome and limited treatment options. The aim of this study is to investigate the clinical benefit and tolerability of weekly intravenous administration of carboplatin-based monotherapy in adult glioma patients who had progressed from previous chemotherapy lines based on temozolomide and nitrosoureas.

Methods

This was a single-arm, phase II study. Eligibility criteria included progressive or recurrent glioma after radiotherapy and chemotherapy-based treatments and Karnofsky performance status (KPS) > 60.

Results

Thirty-two patients (median age 43.5 years) were enrolled to receive weekly carboplatin monotherapy in an intravenous method of administration. The median duration of response was 7.3 months with an overall disease control rate of 31.3%. Median progression-free survival was 2.3 months while overall survival was 5.5 months. Pre-treatment with corticosteroids (i.e. dexamethasone) was associated to clinical benefit in 43.8% of patients. Patients achieving clinical benefit exhibited a longer progression-free survival (4.6 vs. 1.5 months; p > 0.001) and overall survival (7.9 vs. 3.2 months; p = 0.041) compared with those not achieving clinical benefit.

Conclusions

Our findings show that single agent, weekly, intravenous administration of carboplatin may have a role in patients with recurrent glioma and suggest that pre-treatment with corticosteroids may confer survival benefit.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Change history

  • 09 September 2019

    In the original article, the names of authors Mariantonia Carosi and Tatiana Koudriavtseva were incorrectly captured, and author Francesco Cognetti's affiliation was incorrect. The information is correctly shown here.

References

  1. Lapointe S, Perry A, Butowski NA (2018) Primary brain tumours in adults. Lancet 392:432–446

    Article  PubMed  Google Scholar 

  2. Crocetti E, Trama A, Stiller C et al (2012) Epidemiology of glial and non-glial brain tumours in Europe. Eur J Cancer 48(10):1532–1542

    Article  PubMed  Google Scholar 

  3. Brandes AA, Finocchiaro G, Zagonel V et al (2016) AVAREG: a phase II, randomized, noncomparative study of fotemustine or bevacizumab for patients with recurrent glioblastoma. Neuro Oncol 18:1304–1312

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Wen PY, Kesari S (2008) Malignant gliomas in adults. N Engl J Med 359(5):492–507

    Article  CAS  PubMed  Google Scholar 

  5. Franceschi E, Lamberti G, Paccapelo A et al (2018) Third-line therapy in recurrent glioblastoma: is it another chance for bevacizumab? J Neurooncol 139:383–388

    Article  CAS  PubMed  Google Scholar 

  6. Prelaj A, Rebuzzi SE, Grassi M et al (2019) Non-conventional fotemustine schedule as second-line treatment in recurrent malignant gliomas: survival across disease and treatment subgroup analysis and review of the literature. Mol Clin Oncol 10:58–66

    PubMed  Google Scholar 

  7. Davis ME (2016) Glioblastoma: overview of disease and treatment. Clin J Oncol Nurs 20:S2–S8

    Article  PubMed  PubMed Central  Google Scholar 

  8. Mrugala MM, Crew LK, Fink JR, Spence AM (2012) Carboplatin and bevacizumab for recurrent malignant glioma. Oncol Lett 4:1082–1086

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Yung WK, Mechtler L, Gleason MJ (1991) Intravenous carboplatin for recurrent malignant glioma: a phase II study. J Clin Oncol 9(5):860–864

    Article  CAS  PubMed  Google Scholar 

  10. Warnick RE, Prados MD, Mack EE et al (1994) A phase II study of intravenous carboplatin for the treatment of recurrent gliomas. J Neurooncol 19(1):69–74

    Article  CAS  PubMed  Google Scholar 

  11. Reardon DA, Desjardins A, Peters KB et al (2012) Phase II study of carboplatin, irinotecan, and bevacizumab for bevacizumab naive, recurrent glioblastoma. J Neurooncol 107(1):155–164

    Article  CAS  PubMed  Google Scholar 

  12. Francesconi AB, Dupre S, Matos M et al (2010) Carboplatin and etoposide combined with bevacizumab for the treatment of recurrent glioblastoma multiforme. J Clin Neurosci 17(8):970–974

    Article  CAS  PubMed  Google Scholar 

  13. Field KM, Simes J, Nowak AK et al (2015) Randomized phase 2 study of carboplatin and bevacizumab in recurrent glioblastoma. Neuro Oncol 17:1504–1513

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Pignata S, Breda E, Scambia G et al (2008) A phase II study of weekly carboplatin and paclitaxel as first-line treatment of elderly patients with advanced ovarian cancer A Multicentre Italian Trial in Ovarian cancer (MITO-5) study. Crit Rev Oncol Hematol 66:229–236

    Article  PubMed  Google Scholar 

  15. Jatoi A, Stella PJ, Hillman S et al (2003) Weekly carboplatin and paclitaxel in elderly non-small-cell lung cancer patients (≥ 65 years of age): a phase II North Central Cancer Treatment Group study. Am J Clin Oncol. 26:441–447

    Article  CAS  PubMed  Google Scholar 

  16. Wesseling P, Capser D (2018) WHO 2016 classification of gliomas. Neuropathol Appl Neurobiol 44:139–150

    Article  CAS  PubMed  Google Scholar 

  17. Calvert AH, Newell DR, Gumbrell LA et al (1989) Carboplatin dosage: prospective evaluation of a simple formula based on renal function. J Clin Oncol 7:1748–1756

    Article  CAS  PubMed  Google Scholar 

  18. Wen PY, Macdonald DR, Reardon DA et al (2010) Updated Response Assessment Criteria for high grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol 28:1963–1972

    Article  PubMed  Google Scholar 

  19. Prelaj A, Rebuzzi SE, Grassi M et al (2019) Multimodal treatment for local recurrent malignant gliomas: re-surgery and/or re-irradiation followed by chemotherapy. Mol Clin Oncol 10:49–57

    PubMed  Google Scholar 

  20. Taal W, Segers-van Rijn JM, Kros JM et al (2012) Dose dense 1 week on/1 week off temozolomide in recurrent glioma: a retrospective study. J Neurooncol 108:195–200

    Article  PubMed  PubMed Central  Google Scholar 

  21. Roberts N, Wadajkar AS, Winkles JA et al (2016) Repurposing platinum-based chemotherapies for multimodal treatment of glioblastoma. Oncoimmunology 5:e1208876

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Ando M, Minami H, Ando Y et al (2000) Multi-institutional validation study of carboplatin dosing formula using adjusted serum creatinine level. Clin Cancer Res 6:4733–4738

    CAS  PubMed  Google Scholar 

  23. Murray LJ, Bridgewater CH, Levy D (2011) Carboplatin chemotherapy in patients with recurrent high-grade glioma. Clin Oncol 23:55–61

    Article  CAS  Google Scholar 

  24. Pitter KL, Tamagno I, Alikhanyan K et al (2016) Corticosteroids compromise survival in glioblastoma. Brain 139:1458–1471

    Article  PubMed  PubMed Central  Google Scholar 

  25. Wong ET, Lok E, Gautam S, Swanson KD (2015) Dexamethasone exerts profound immunologic interference on treatment efficacy for recurrent glioblastoma. Br J Cancer 113:232–241

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Wong E, Swanson KD (2019) Dexamethasone-friend or foe for patients with glioblastoma? JAMA Neurol. 1:11. https://doi.org/10.1001/jamaneurol.2018.4530

    Article  Google Scholar 

  27. Cenciarini M, Valentino M, Belia S et al (2019) Dexamethasone in glioblastoma multiforme therapy: mechanisms and controversies. Front Mol Neurosci 12:65

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Editorial assistance was provided by Luca Giacomelli, PhD, Chiara Degirolamo, PhD, and Aashni Shah, from Polistudium (Milan, Italy); this assistance was supported by internal funds.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alessandra Fabi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human and/or animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Regina Elena Institute, Rome, Italy) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Villani, V., Pace, A., Vidiri, A. et al. Phase II study of weekly carboplatin in pretreated adult malignant gliomas. J Neurooncol 144, 211–216 (2019). https://doi.org/10.1007/s11060-019-03223-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-019-03223-x

Keywords

Navigation