scholarly journals Effect of valproic acid on overall survival in patients with high-grade gliomas undergoing temozolomide

Medicine ◽  
2020 ◽  
Vol 99 (28) ◽  
pp. e21147
Author(s):  
Yu-Jen Kuo ◽  
Yao-Hsu Yang ◽  
I-Yun Lee ◽  
Pau-Chung Chen ◽  
Jen-Tsung Yang ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Overall Survival ◽  
High Grade ◽  
High Grade Gliomas

An analysis of two different schedules of radiochemotherapy with concomitant temozolomide in high grade gliomas

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 2035-2035 ◽  
Author(s):  
G. R. D’Agostino ◽  
M. Balducci ◽  
C. Anile ◽  
S. Manfrida ◽  
G. Di Lella ◽  
...  
Keyword(s):  
Overall Survival ◽  
Statistical Significance ◽  
Residual Tumor ◽  
Hematological Toxicity ◽  
High Grade ◽  
Safe Alternative ◽  
Neurological Toxicity ◽  
Tumor Bed ◽  
Historical Series ◽  
High Grade Gliomas

2035 Background: We compared two different schedules of temozolomide (TMZ) concomitant therapy in terms of toxicity and outcome. Methods: 70 patients (median age 61 years, range 27–80) affected by high grade gliomas were treated with concomitant chemoradiation. Conformal radiotherapy (5,940 cGy, 180 cGy/day; CTV2: tumor bed + residual tumor if present + oedema, 3,960 cGy; CTV1: tumor bed + residual tumor if present + margins, 1,980 cGy) was associated with one of the following TMZ schedules: TMZ1: (75 mg/m2 × 5 days, first and last week of radiotherapy); TMZ2 (75 mg/m2, 7 days/week, from the first to the last day of radiotherapy); Toxicities were graded according to RTOG criteria. Survival analysis based on the Kaplan-Meier model. Results: From October, 2000 to March, 2006, 54 patients high grade gliomas were evaluated. 41 patients (29 GBL, 70.7%; 12 AA, 29.3%) were treated between October 2003 and March 2006 with TMZ2, and compared to an historical series of 29 patients (25 GBL, 86.2%; 4 AA, 13.%) treated in our Institution before 2003 with TMZ1. All patients received adjuvant chemotherapy with TMZ for 6 cycles or until disease progression. Hematological toxicity was mild in both group, whereas neurological toxicity (seizures) was higher in TMZ2 group, with a grade > 2 toxicity registered in 11/41 pts (26.8%) compared to 1/29 of the TMZ1 group (3.5%), even if this difference failed to achieve statistical significance (p=0.06). The overall survival did not significantly differ among the 2 schedules (p=0.60). In fact, at a median follow-up of 21 months (range 3- 68), median survival time was 21 months and 19 months, for TMZ1 and TMZ2 groups, respectively, with a 1-year and 2-year overall survival of 73.1% in the TMZ1 group and 75.3% in the TMZ2 group, respectively. Conclusions: In our experience, the concomitant administration of TMZ at the daily dose of 75 mg/m2 given continuously or only in the first and the last week of radiotherapy obtained comparable results in terms of outcome, with a heavier neurological toxicity when given 7 days per week, from the first to the last day of radiotherapy. These data suggest that, in selected cases, the TMZ1 schedule can be considered as a safe, alternative strategy, which does not impact significantly on patient outcome, compared to the standard TMZ2. No significant financial relationships to disclose.

Association of leukocyte count (neutrophilia and lymphopenia) with poor prognosis in patients with high-grade gliomas in a Guatemalan cohort.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14500-e14500
Author(s):  
Rixci Ramirez ◽  
Daniel Estuardo Rosales Lopez ◽  
Jennifer Dominguez ◽  
Marisol Gramajo ◽  
Carolina Camey
Keyword(s):  
Overall Survival ◽  
Neutrophil Count ◽  
Prognostic Value ◽  
Univariate Analysis ◽  
Rank Test ◽  
Significant Prognostic Factor ◽  
High Grade ◽  
Initial Surgery ◽  
High Grade Gliomas ◽  
Clinical Records

e14500 Background: In previous studies separately, it has already been determined how the inflammatory response measured by it neutrophilia and also lymphopenia s with temozolamide have determined that they are important at the time of initiation of treatment and have a prognostic value in patients with high-grade gliomas, the objective This study was the prognostic value of leukocyte disorders, absolute neutrophil count and absolute lymphocyte count in a retrospective cohort of patients with high-grade glioma who receive concomitant temozolomide and radiation plus maintenance. Methods: Clinical records of patients treated at the Guatemalan Social Security Institute were registered in the Oncology service within the period from January 1, 2013 to December 2018, the treatment consisted of temozolomide (75 mg / m2 per day) and concomitant radiation and subsequent maintenance with temozolomide (150 mg / m2 D1-5) every 28 days for 6 cycles. The prognostic value of neutrophilia and lymphopenia, prior to treatment in survival, was defined as a neutrophil count greater than 7x10 3 / uL and lymphopenia less than 2 x10 3 / uL. The analysis was performed using Kapplan Mayer curves, log rank test and Cox analysis. Results: We identified 64 high-grade patients (grades III and IV according to WHO), all treatments with concomitant chemoradiotherapy based on temozolomide and subsequent maintenance with temozolamide. The initial surgery was lost in the majority (75%), with resection > 90% in 25 patients (34%). 79.4% were treated with radiotherapy plus concomitant chemotherapy followed by adjuvant chemotherapy with temozolamide of these, 69% completed the treatment, thirty-two patients (50%) with pre-treatment neutrophilia. The overall survival at 2 years was 55%. In the univariate analysis, neutrophilia is associated with a worse overall survival (p = 0.019), as well as lymphopenia (p = 0.003), in addition to the age ≥65 years (p = 0.0001), surgical resection < 90% (p = 0.045) and prednisolone consumption ≥50mg / day (p = 0.045). In the multivariate analysis, neutrophilia (p = 0.017), age ≥65 (p = 0.001), lymphopenia (p = 0.0056) were associated with a worse prognosis with reduced survival. Conclusions: In high-grade gliomas treated with temozolomide and concomitant radiation followed by maintenance with temozolamide, neutrophilia and lymphopenia can be a significant prognostic factor for overall survival, with the advantage that it is not an expensive test and is accessible at all times of patient follow-up.

Pediatric high grade gliomas: Clinico-pathological profile, therapeutic approaches and factors affecting overall survival

2019 ◽  
Vol 65 (2-3) ◽  
pp. 63-68
Author(s):  
O. Boudaouara ◽  
S. Charfi ◽  
M. Bahri ◽  
J. Daoud ◽  
M.Z. Boudawara ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Grade ◽  
Therapeutic Approaches ◽  
Factors Affecting ◽  
High Grade Gliomas

scholarly journals TAMI-54. THE PRESENCE OF IMMUNE CELL INFILTRATES IN THE TISSUE MICROENVIRONMENT OF HIGH-GRADE GLIOMAS AND THEIR ASSOCIATION WITH OVERALL SURVIVAL

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii225-ii225
Author(s):  
Anupam Rishi ◽  
Homan Mohammadi ◽  
Daniela Martir ◽  
Eric Welsh ◽  
Timothy Robinson ◽  
...  
Keyword(s):  
Gene Expression ◽  
Overall Survival ◽  
Surgical Resection ◽  
Immune Cell ◽  
Cox Regression ◽  
Tumor Biology ◽  
Rank Test ◽  
High Grade ◽  
High Grade Gliomas ◽  
Grade 3

Abstract OBJECTIVE Tumor-associated microglia and macrophages (TAMs) influence brain tumor biology and promote tumor-proliferating phenotype. Studies have shown these cell types predict outcomes in various tumor sites with limited evidence in high-grade gliomas (HGG). In this study, we assessed the presence of immune cell infiltrate (ICI) and overall survival (OS) in HGGs. METHODS A total of 97 consecutively treated patients with primary HGG with complete gene expression profiling were identified from our IRB-approved institutional tissue biorepository. Patients underwent primary surgical resection between 02/2004 and 03/2011. Gene expression levels were assessed by Affymetrix Hu-RSTA assays (Affymetrix; Santa Clara, CA). CIBERSORT estimated the presence of ICI via gene expression deconvolution. Tumor characteristics and the presence of 22 individual ICI subtypes were assessed with respect to OS. Time-to-event analyses were performed with Kaplan-Meier estimates and compared via log-rank test. Associations between the ICI and outcomes were explored using Cox-regression. P&lt; 0.05 (two-tailed) was considered statistically significant. RESULTS Median follow-up from primary surgical resection was 12.8 months (range: 0.1-162.8), and median age was 58 years (20-85). Most patients were male (n=63; 65%) and had grade 4 tumors (n=71; 73%). OS differed by grade with 24-month actuarial OS rates of 81% and 34% (P&lt; 0.0001) for grade 3 and 4 gliomas, respectively. The presence of M0 (HR 2.2; 95% CI 1.4-3.6; P=0.001), M1 (HR 1.8; 95%CI 1.1-2.9; P=0.01), and M2 macrophages (HR 1.9; 95%CI 1.2-3.2; P=0.007) predicted OS. No other ICI subtypes were predictive of OS. The presence of M0- and M2-polarized macrophages were more common in grade 4 compared to grade 3 gliomas 46% vs. 11% (P=0.002) and 69% vs. 31% (P=0.0007), respectively. CONCLUSION The increased presence of non-polarized or M2 TAMs within the glioma microenvironment was significantly associated with OS in HGG. Their presence may serve as unique stratification and a potential therapeutic target.

Effect of metformin and statins in high-grade brain tumors.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 2091-2091
Author(s):  
Guek Eng Lee ◽  
Iain B. Tan ◽  
Chee Kian Tham
Keyword(s):  
Diabetes Mellitus ◽  
Overall Survival ◽  
Confidence Interval ◽  
Median Survival ◽  
Brain Tumours ◽  
High Dose ◽  
Average Dose ◽  
High Grade ◽  
Anti Cancer ◽  
High Grade Gliomas

2091 Background: Metformin and statins are thought to have anti-cancer properties. Metformin induces AMPK activation and may be implicated in potentiating the therapeutic outcome of temazolamide. Statins at low dose are thought to have anti-cancer properties by inhibiting pro-angiogenic factors with resultant inhibition of tumor growth, but statins at high dose are thought to have counter-productive effects. Hyperglycaemia was shown to be associated with a poorer outcome in patients with newly diagnosed glioblastoma. Hence we investigate the effect of metformin and statins in high grade brain tumours. Methods: Among 249 patients with brain tumour, we identified 142 patients with high grade gliomas. 116 patients did not receive metformin or statins and 26 patients received metformin or statins. Patients’ demographics, clinical and histopathological characteristics were recorded. Overall survival was evaluated. Results: Among 142 patients with high grade gliomas, there were 86 patients with glioblastoma multiforme, and 56 patients with anaplastic astrocytoma or anaplastic oligodendroma. Median age was 60 years old. The average value of HbA1c value for patients on metformin was 7.2%. The average dose of simvastatin used was 20 mg and average total cholesterol was 5.1mmol/l. For patients who did not receive metformin or statins, the median survival was 72.9 months (95% confidence interval, 47.8 – 98.1); patients who received metformin or statins, the median survival was 39.1 months (95% confidence interval, 21.7 – 56.4) p = 0.24. Conclusions: There is a trend towards shorter overall survival of patients who received metformin and statins. Despite the anti-cancer properties of metformin and statins, patients with diabetes mellitus and hyperlipidaemia still fare worse. The effect of diabetes mellitus, hyperlipidaemia, as well as sugar and cholesterol control deserves a larger cohort study in patients with high grade brain tumours.

scholarly journals P08.34 Overall survival of primary high-grade gliomas of supra- and infratentorial midline structures

2016 ◽  
Vol 18 (suppl_4) ◽  
pp. iv48-iv49
Author(s):  
C. A. Hamisch ◽  
S. Kellermann ◽  
T. Blau ◽  
S. Grau ◽  
R. Goldbrunner ◽  
...  
Keyword(s):  
Overall Survival ◽  
High Grade ◽  
High Grade Gliomas

scholarly journals Laser Ablation of Newly Diagnosed Malignant Gliomas

Neurosurgery ◽  
2016 ◽  
Vol 79 (suppl_1) ◽  
pp. S17-S23 ◽  
Author(s):  
Michael E. Ivan ◽  
Alireza M. Mohammadi ◽  
Nicoleta De Deugd ◽  
Joshua Reyes ◽  
Gregor Rodriguez ◽  
...  
Keyword(s):  
Overall Survival ◽  
Minimally Invasive ◽  
Progression Free Survival ◽  
Small Sample ◽  
Invasive Technique ◽  
High Grade ◽  
Newly Diagnosed ◽  
Free Survival ◽  
High Grade Gliomas

Abstract BACKGROUND: Magnetic resonance-guided laser-interstitial thermotherapy (MR-LITT) is a minimally invasive technique that shows promise in neuro-oncology because of its superiority in delivering precise minimally invasive thermal energy with minimal collateral damage. OBJECTIVE: In this analysis, we investigate initial data on the use of MR-LITT in the treatment of newly diagnosed high-grade gliomas. METHODS: With the use of the PubMed, OVID, and Google-scholar database systems, a comprehensive search of the English literature was performed. Eighty-five articles were identified plus 1 that is pending publication. Four articles were accounted for in this review, including 25 patients with newly diagnosed high-grade gliomas who underwent MR-LITT treatment. We evaluated safety, progression-free survival, and overall survival. RESULTS: Twenty-five patients with a mean age of 53.8 years underwent LITT treatments. On average, 82.9% of the pretreatment lesion volume was ablated. The average tumor volume treated was 16.5 cm3. The mean follow-up time was 7.6 months. Median overall survival was found to be 14.2 months (range 0.1-23 months). The median progression-free survival was 5.1 months (range 2.4-23 months); however, these data are limited by the relatively short follow-up of the patients reviewed and small sample size of only 25 patients. There was 1 (3.4%) major perioperative complication, which was a central nervous system infection. CONCLUSION: MR-LITT is a promising technology for the treatment of small, yet difficult-to-treat newly diagnosed high-grade gliomas. This study demonstrates that MR-LITT is safe, and future randomized studies are needed to evaluate its role as a treatment adjunct for newly diagnosed high-grade gliomas.

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