Abstract
Abstract BACKGROUND There is currently no consensus on how best to treat diffuse glioma in adults at recurrence. Etoposide in combination with carboplatin and/or bevacizumab has been evaluated in recurrent glioma with modest efficacy. This retrospective study investigates the efficacy of etoposide monotherapy in adults with recurrent diffuse glioma. MATERIAL AND METHODS In this single center retrospective series, all adult patients with radiographically proven multiply recurrent diffuse glioma (WHO grade 2-4) treated with etoposide between 2016 and 2020 were evaluated. Progression-free survival (PFS) and overall survival (OS) after initiating etoposide were calculated for the total group and for different histologic tumor types. In addition, toxicity was recorded after initiation of etoposide. RESULTS 48 patients with a median age 43 (range 24-78) were included. Etoposide was given as 3rd line of treatment in 18 patients (37.5%) and as 4th or 5th line of treatment in 30 patients (62.5%). The majority were diagnosed with a glioblastoma, WHO grade 4 (27, 56.3%). The median PFS was 8.6 weeks (95% confidence interval [CI]: 8.3-8.9). The median OS of the total population was 4.0 months (95% CI: 2.4-5.6). Patients with an oligodendroglioma had the best OS (median 13 months), compared to astrocytoma and glioblastoma, but the difference was not statistically significant (p=0.152). Etoposide was stopped due to progression or toxicity. Only 1 patient had a grade 3 toxicity. CONCLUSION Etoposide is a well-tolerated chemotherapy in adult patients with recurrent diffuse glioma, but has limited efficacy in this cohort of multiply recurrent and heavily pretreated patients.
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