scholarly journals Efficacy and safety of long-term therapy for high-grade glioma with temozolomide: A meta-analysis

Oncotarget ◽  
2017 ◽  
Vol 8 (31) ◽  
pp. 51758-51765 ◽  
Author(s):  
Weilin Xu ◽  
Tao Li ◽  
Liansheng Gao ◽  
Jingwei Zheng ◽  
Anwen Shao ◽  
...  
2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 8015-8015 ◽  
Author(s):  
Gareth J Morgan ◽  
Graham H. Jackson ◽  
Faith Davies ◽  
Ping Wu ◽  
Walter Gregory ◽  
...  

8015 Background: Bisphosphonates (BPs) are recommended in pts with osteolytic lesions from MM. However, data on the long-term efficacy and safety of BPs beyond 2 y is somewhat limited. The MRC Myeloma IX study has already revealed significant overall survival (OS) and progression-free survival (PFS) benefits for zoledronic acid (ZOL) over clodronate (CLO) in MM pts (N = 1960) initiating chemotherapy (Morgan GJ, et al. Lancet. 2010). We now report the efficacy and safety of BP therapy with long-term follow-up. Methods: Newly diagnosed MM pts were randomized to ZOL (4 mg IV q 21-28 days) or CLO (1600 mg/day PO) plus antimyeloma therapy. BPs continued at least until disease progression. PFS and OS were estimated using Kaplan-Meier methodology. Hazard ratios (HRs) were calculated using stratified Cox models. Adverse events (AEs) were monitored continuously and analyzed using cumulative incidence functions. Results: At a median follow-up of 5.8 y in 1960 evaluable pts, ZOL improved PFS (HR = 0.88; P = .01) and OS (HR = 0.88; P = .03) vs CLO. Both BPs were generally well tolerated, and acute renal failure events were similar between groups (ZOL 5.2% vs CLO 5.8% at 2 y, with incidence plateaued thereafter). Overall incidence of confirmed osteonecrosis of the jaw (ONJ) has remained low (ZOL 3.7% vs CLO 0.5%; P < .0001). ONJ incidence was lower among pts receiving thalidomide-containing regimens (1.4%) vs no thalidomide (2.76%; P = .041). Events were generally low-grade, most occurred between 8 and 30 mo (median time to ONJ = 23.7 mo), and cumulative incidence plateaued at ~36 mo. Ten pts had data on ONJ recovery: complete recovery in 4 pts, improvement in 2 pts, no change in 3 pts in the ZOL group; and no change in 1 CLO pt. Dental surgery or trauma preceded ONJ in 6 ZOL pts. Conclusions: ZOL provided sustained PFS and OS improvements vs CLO during long-term therapy in the MRC Myeloma IX study. Overall incidence of AEs was similar between groups, with no notable changes during long-term therapy. ONJ incidence remained low during long-term (> 2.5 y) therapy and was reduced in pts receiving thalidomide (possibly because of anticytokine effects of this agent).


2014 ◽  
Vol 46 ◽  
pp. e140 ◽  
Author(s):  
M. Fasano ◽  
M. Ciarallo ◽  
A. Giammario ◽  
B. Caccianotti ◽  
G. Angarano ◽  
...  

2019 ◽  
Author(s):  
Shengnan Zhang ◽  
Libo Xu ◽  
Guanyu Chen ◽  
Jiangmin Liu ◽  
Qian Wang ◽  
...  

Abstract BACKGROUND: Immunotherapy combined with standard of care (SOC) is often used for high-grade glioma (HGG). There are few comparisons of immunotherapy with SOC treatment or without SOC treatment (IMT) versus SOC. It is important to understand what interventions exist and their relative effectivenesses. METHODS: The Cochrane Library, Embase, Medline, and the Web of Science Core Collection were systematically searched by two librarians. Retrieved hits were screened for inclusion. Subgroup analysis was used to examine the main factors associated with overall survival (OS) and progression-free survival (PFS), which were used as primary endpoints to assess the efficacy and safety of IMT. This study was registered with PROSPERO, number CRD42019112356. RESULTS: The search yielded 2,315 results, of which 11 met the eligibility criteria. We identified 6 publications through exploration. Compared to SOC alone, IMT including viral therapy (VT) and dendritic cell vaccination improved the OS (HR = 0.55, 95% CI 0.42-0.72; p < 0.0001) and PFS (HR = 0.67, 95% CI 0.53-0.84; p = 0.0005). CONCLUSIONS: We found that IMT in the era of TMZ has an improved effectiveness over SOC. Our findings support the use of immunotherapy for brain tumors to improve HGG outcomes.


2018 ◽  
Vol 43 (5) ◽  
pp. 277-283 ◽  
Author(s):  
Francisco Vivancos-Matellano ◽  
Ana Rodríguez-Sanz ◽  
Yolanda Herrero-Infante ◽  
Javier Mascías-Cadavid

1997 ◽  
Vol 17 (03) ◽  
pp. 161-162
Author(s):  
Thomas Hyers

SummaryProblems with unfractionated heparin as an antithrombotic have led to the development of new therapeutic agents. Of these, low molecular weight heparin shows great promise and has led to out-patient therapy of DVT/PE in selected patients. Oral anticoagulants remain the choice for long-term therapy. More cost-effective ways to give oral anticoagulants are needed.


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