Phase II trial of temozolomide and cisplatin followed by whole brain radiotherapy in non-small-cell lung cancer patients with brain metastases: a GLOT-GFPC study
Open Access
- 21 June 2006
- journal article
- research article
- Published by Elsevier BV in Annals of Oncology
- Vol. 17 (9), 1412-1417
- https://doi.org/10.1093/annonc/mdl146
Abstract
Background: Brain metastases (BM) considerably worsen the prognosis of non-small-cell lung cancer (NSCLC) patients. The usefulness and choice of chemotherapy remain uncertain in this indication since these patients are excluded from most clinical trials. We conducted a phase II study to determine the efficacy and tolerability of up-front chemotherapy with association of temozolomide and cisplatin in NSCLC patients with BM. Patients and methods: Fifty NSCLC patients with BM received temozolomide (200 mg/m2/day for 5 days every 28 days) and cisplatin (75 mg/m2 at day 1 of each cycle), up to six cycles, followed by whole brain radiotherapy (WBRT). An evaluation was carried out every two cycles and after WBRT. WBRT was performed earlier in case of progressive disease at any time or stable disease after cycle 4. Results: Eight objective responses were achieved (16%). Overall median survival was 5 months. Median time to progression was 2.3 months. Ten patients (20%) presented a grade 3/4 neutropenia and 11 patients (22%) presented a grade 3/4 thrombopenia. Conclusion: This study demonstrates a lack of efficacy of up-front chemotherapy with association of temozolomide and cisplatin in these patients. Nevertheless, it supports the feasibility of chemotherapy before brain radiotherapy in NSCLC patients with BM.Keywords
This publication has 18 references indexed in Scilit:
- Oral temozolomide in heavily pre-treated brain metastases from non-small cell lung cancer: Phase II studyLung Cancer, 2005
- Plasma and Cerebrospinal Fluid Population Pharmacokinetics of Temozolomide in Malignant Glioma PatientsClinical Cancer Research, 2004
- Temozolomide in patients with advanced non-small cell lung cancer with and without brain metastasesEuropean Journal Of Cancer, 2003
- Phase II study of temozolomide in heavily pretreated cancer patients with brain metastasesAnnals of Oncology, 2001
- A Phase II Trial of Temozolomide for Patients with Recurrent or Progressive Brain MetastasesJournal of Neuro-Oncology, 2001
- Randomized Phase III Study of Temozolomide Versus Dacarbazine in the Treatment of Patients With Advanced Metastatic Malignant MelanomaJournal of Clinical Oncology, 2000
- Multicenter Phase II Trial of Temozolomide in Patients With Anaplastic Astrocytoma or Anaplastic Oligoastrocytoma at First RelapseJournal of Clinical Oncology, 1999
- The role of radiation therapy in the treatment of brain metastasesInternational Journal of Radiation Oncology*Biology*Physics, 1992
- A Randomized Trial of Surgery in the Treatment of Single Metastases to the BrainNew England Journal of Medicine, 1990
- Inactivation of O6-alkylguanine-DNA alkyltransferase in HeLa cells by cisplatinCarcinogenesis: Integrative Cancer Research, 1989