The efficacy of interferon-β and temozolomide combination therapy for newly diagnosed primary glioblatoma: Multicenter study.

Abstract

2015 Background: Interferon-β (IFN-β) elicits pleiotropic biological effects such as antiproliferation, immunomodulation, and cell differentitative and has been widely used either alone or in combination with other antitumor agents in the treatment of malignant brain tumors. In this study, we evaluated the efficacy of IFN-β combined with standard of radiation (RT) and temozolomide (TMZ) for newly-diagnosed primary glioblastoma (GBM). Methods: This study included 54 consecutive patients with newly diagnosed primary GBM who underwent surgical treatment and received standard radiotherapy with concurrent TMZ at the standard Stupp regimen. Of total 54 patients, 27 patients (50%) received IFN-β in combination of TMZ. There were no significant differences in any of clinical parameters. Results: Median progression-free survival (PFS) and overall survival (OS) of all patients were 11.7 and 17.2 months, respectively. Multivariate analysis revealed methylated MGMT promoter (p= 0.005) and the combination of TMZ and IFN-β (p= .016) as independent prognostic factors associated with longer OS. Median OS of the combination group was significantly longer with 22.3 months (95% CI, 18.3 to 26.3) compared to TMZ alone group with 12.7 months (95% CI, 10.2 to 15.2). Notably, in even patients whose tumors had unmethylated MGMT promoter, median OS prolonged to 17.6 months (95%CI, 13.8 to 21.3) when receiving TMZ with IFN-β, compared to 12.7 months (95%CI, 11.7 to 13.7) in those receiving TMZ without IFN-β (p= 0.003). Furthermore in the subpopulation analysis of benefit from the use of IFN-β combination, there were significant associations with deep tumor location (p= 0.049), GTR negative (p= 0.030), ummethylated MGMT status (p= 0.018), and p53 mutation (p= 0.044). Conclusions: Addition of IFN-β to the standard regimen of TMZ and RT for newly diagnosed GBM showed promising efficacy. IFN-β and TMZ combination group achieved a favorable outcome, particularly in patients with unmethylated MGMT promoter. Survival data of unmethylated MGMT patients All patients TMZ with IFN-β TMZ without IFN-β Median OS (months) 15.1 17.6 12.7 12M-OS (%) 75 82 67 24M-OS (%) 23 33 11 No significant financial relationships to disclose.