Abstract
BACKGROUND: Nitrosoureas are frequently used in treatment of patients with high grade gliomas (HGG). We reviewed our institutional experience with HGG patients treated with lomustine. METHODS: After IRB approval, Cleveland Clinic's database was used to identify HGG patients treated at our institution between 2007 and 2014. Multivariable analysis was conducted with use of a COX proportional hazards model and a stepwise selection algorithm that used p = .10 and p = .05 for the entry and retention criteria. RESULTS: 98 HGG patients treated with lomustine were included for this analysis. 53 patients received lomustine alone, 28 received lomustine and bevacizumab, and 17 received lomustine with other agents with or without bevacizumab. The median PFS of lomustine with bevacizumab (n = 8) versus lomustine alone (n = 11) was 13 months versus 3.5 months(p = .003); while those with EGFR amplified tumors in lomustine with bevacizumab (n = 6) versus lomustine alone (n = 8) had a median PFS of 7 months versus 5.5 months, respectively (p = 0.98). CONCLUSION: Lomustine and bevacizumab improved PFS in recurrent EGFR wild type HGG in this series. EGFR amplification status may serve as a molecular marker that predicts benefit with lomustine and bevacizumab combination.
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call