Clinical activity of regorafenib in elderly patients with recurrent glioblastoma.
elderly
glioblastoma
isocitrate dehydrogenase
methylated methylguanine-DNA-methyltransferase (MGMT)
regorafenib
Journal
Molecular and clinical oncology
ISSN: 2049-9469
Titre abrégé: Mol Clin Oncol
Pays: England
ID NLM: 101613422
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
14
07
2022
accepted:
10
11
2022
entrez:
10
2
2023
pubmed:
11
2
2023
medline:
11
2
2023
Statut:
epublish
Résumé
Glioblastoma multiforme is one of the most frequent and aggressive primary tumors in the central nervous system, representing >60% of all brain tumors in adults. Despite treatment, prognosis remains poor with most if not all patients experiencing disease recurrence and a 2-year survival rate of 27%. At present, no confirmed standard treatment exists for recurrent glioblastoma. Regorafenib is one of the few options available, based on results from the REGOMA trial. In the present study, a real-life retrospective investigation on the role of regorafenib in patients with recurrent glioblastoma (>60 years old) from two main Oncological Units in South Italy (Azienda Ospedaliera Universitaria Luigi Vanvitelli, Naples, Italy and Ospedale Civile San Giovanni di Dio, Frattamaggiore, Naples, Italy), was performed. The primary endpoint was overall survival (OS), whereas progression-free survival (PFS), objective response rate and disease control were secondary endpoints. Survival was then analyzed according to age, isocitrate dehydrogenase (IDH) and methylated methylguanine-DNA-methyltransferase (MGMT) status. A total of 56 patients met the eligibility criteria. The intention to treat population median PFS (mPFS) was 4.1 months and median OS (mOS) was 6.8 months. Age did not appear to have a significant influence on mPFS. mOS in MGMT-methylated patients was improved compared with that of the unmethylated group (7.7 months vs. 5.6 months). Both mOS and mPFS were longer in IDH-mutant patients. The present study was one of the first real life analyses of regorafenib in recurrent glioblastoma. The results were in line with the REGOMA trial. Age did not appear to be a prognostic factor, thus suggesting that treatment choice should not be different in elderly. MGMT methylation appeared to influence OS. To the best of our knowledge, this was the first report of regorafenib activity in older patients and, while the results were statistically significant, these should be confirmed in further studies.
Identifiants
pubmed: 36761386
doi: 10.3892/mco.2023.2605
pii: MCO-18-2-02605
pmc: PMC9905649
doi:
Types de publication
Journal Article
Langues
eng
Pagination
9Informations de copyright
Copyright: © Fasano et al.
Déclaration de conflit d'intérêts
MF: Advisory boards for MSD and Merck Serono. All other authors declare that they have no competing interests.
Références
Cancer Treat Rev. 2018 Jan;62:61-73
pubmed: 29175677
Curr Neurol Neurosci Rep. 2021 Nov 24;21(12):68
pubmed: 34817716
Nat Rev Clin Oncol. 2021 Mar;18(3):170-186
pubmed: 33293629
Lancet Oncol. 2009 May;10(5):459-66
pubmed: 19269895
Asian Pac J Cancer Prev. ;18(1):3-9
pubmed: 28239999
Neuro Oncol. 2021 Aug 2;23(8):1231-1251
pubmed: 34185076
World J Gastroenterol. 2017 Jul 14;23(26):4675-4688
pubmed: 28765689
Cancers (Basel). 2020 Dec 15;12(12):
pubmed: 33333830
Cochrane Database Syst Rev. 2021 May 4;5:CD013579
pubmed: 34559423
Brain Pathol. 2010 Jan;20(1):245-54
pubmed: 19903171
Nat Rev Clin Oncol. 2018 Oct;15(10):599-616
pubmed: 30061739
Neurooncol Pract. 2016 Jun;3(2):77-86
pubmed: 31386084
Future Oncol. 2018 Sep;14(22):2239-2246
pubmed: 29569472
Biomedicines. 2022 Mar 10;10(3):
pubmed: 35327445
Acta Neuropathol. 2012 Oct;124(4):547-60
pubmed: 22810491
N Engl J Med. 2016 Apr 7;374(14):1344-55
pubmed: 27050206
J Mol Diagn. 2008 Jul;10(4):332-7
pubmed: 18556773
Lancet. 2018 Mar 31;391(10127):1301-1314
pubmed: 29307467
Lancet Oncol. 2019 Jan;20(1):110-119
pubmed: 30522967
Clin Cancer Res. 2013 Feb 15;19(4):764-72
pubmed: 23209033
Lancet. 2013 Jan 26;381(9863):303-12
pubmed: 23177514
N Engl J Med. 2005 Mar 10;352(10):997-1003
pubmed: 15758010
J Clin Oncol. 2013 Sep 10;31(26):3212-8
pubmed: 23940216
Neuro Oncol. 2019 Jul 11;21(7):954-955
pubmed: 31089718
JAMA Oncol. 2018 Sep 1;4(9):1254-1262
pubmed: 29931168
N Engl J Med. 2017 Nov 16;377(20):1954-1963
pubmed: 29141164
J Cancer Res Clin Oncol. 2019 Apr;145(4):1037-1042
pubmed: 30820715
Neuro Oncol. 2019 Nov 1;21(Suppl 5):v1-v100
pubmed: 31675094
Lancet. 2017 Jan 7;389(10064):56-66
pubmed: 27932229
Neuro Oncol. 2021 Feb 25;23(2):264-276
pubmed: 32661549
Cancers (Basel). 2021 Sep 21;13(18):
pubmed: 34572958
N Engl J Med. 2005 Mar 10;352(10):987-96
pubmed: 15758009
CNS Oncol. 2019 Jun 1;8(2):CNS32
pubmed: 31290692
JAMA Oncol. 2020 Apr 1;6(4):495-503
pubmed: 32027343