Journal of Clinical Oncology, Vol 17, Issue 8
(August), 1999: 2572
© 1999 American Society for Clinical Oncology
Outcomes and Prognostic Factors in Recurrent Glioma Patients Enrolled Onto Phase II Clinical Trials
Eric T. Wong,
Kenneth R. Hess,
Mary Jo Gleason,
Kurt A. Jaeckle,
Athanassios P. Kyritsis,
Michael D. Prados,
Victor A. Levin,
W.K. Alfred Yung
From the Departments of Neuro-Oncology and Biomathematics, The University of Texas M.D. Anderson Cancer Center, Houston, TX; and Department of Neurological Surgery, University of California, San Francisco, CA.
Address reprint requests to W.K. Alfred Yung, MD, Department of Neuro-Oncology, Box 100, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030.
 |
ABSTRACT
|
|---|
PURPOSE: To determine aggregate outcomes and prognostic covariates in patients with recurrent glioma enrolled onto phase II chemotherapy trials.
PATIENTS AND METHODS: Patients from eight consecutive phase II trials included 225 with recurrent glioblastoma multiforme (GBM) and 150 with recurrent anaplastic astrocytoma (AA). Their median age was 45 years (range, 15 to 82 years) and their median Karnofsky performance score was 80 (range, 60 to 100). Prognostic covariates were analyzed with respect to tumor response, progression-free survival (PFS), and overall survival (OS) by multivariate logistic and Cox proportional hazards regression analyses.
RESULTS: Overall, 34 (9%) had complete or partial response, whereas 80 (21%) were alive and progression-free at 6 months (APF6). The median PFS was 10 weeks and median OS was 30 weeks. Histology was a robust prognostic factor across all outcomes. GBM patients had significantly poorer outcomes than AA patients. The APF6 proportion was 15% for GBM and 31% for AA, whereas the median PFS was 9 weeks for GBM and 13 weeks for AA. Results were also significantly poorer for patients with more than two prior surgeries or chemotherapy regimens.
CONCLUSION: Histology is a dominant factor in determining outcome in patients with recurrent glioma enrolled onto phase II trials. Future trials should be designed with separate histology strata.
|
INTRODUCTION
|
|---|
PATIENTS WITH RECURRENT malignant gliomas, such as glioblastoma multiforme (GBM) and anaplastic astrocytoma (AA), have poor outcome. Repeat surgery may not be feasible because of tumor infiltration into eloquent areas of the brain, and additional irradiation has limited control on further tumor growth and would potentiate neurologic toxicity. Facing limited treatment options, patients are usually enrolled onto chemotherapy trials and receive investigational drugs. Published phase II trials for malignant gliomas often include a population with heterogeneous clinical characteristics. Although several prognostic factors are well established for patients newly diagnosed with malignant gliomas, those that are important at recurrence have not been extensively studied.
Age, histology, extent of surgery, and performance status are important prognostic variables for malignant gliomas at initial diagnosis. First, age significantly affects survival1 and strongly correlates with chemosensitivity of these tumors to nitrosourea in vitro2 and in clinical series.3 Second, histology, particularly the presence of necrosis as in GBM, is another important prognostic factor.1,4 The median survival from initial diagnosis is 11 months for GBM as compared with 27 months for AA.5 Third, although preoperative tumor size has no prognostic significance, a major reduction in postoperative size prolongs patient survival, particularly in those with minimal residual disease after at least two log units of tumor removal.6 Lastly, multiple clinical trials have found performance status, in either Karnofsky performance score (KPS) or Eastern Cooperative Oncology Group scales, to be a significant prognostic variable.5,7
However, the prognostic factors for patients with recurrent malignant gliomas remain unclear. Because phase II trials typically enroll patients with recurrent disease after they have failed established therapies, the small number of patients in each of these studies, typically 14 to 30 subjects,8 precludes a robust analysis of prognostic variables because of insufficient statistical power. Eagan and Scott9 combined 103 patients with recurrent malignant gliomas from five chemotherapy trials and found that none of the prognostic factors correlated with response or time to progression (TTP), except for performance score, which correlated with survival. However, their study was published more than a decade ago, and improvements in neuroimaging, surgical techniques, and chemotherapy may alter the prognosis of current patients. Moreover, a recently published phase II study on 51 adults with recurrent malignant gliomas suggested that histology, myelotoxicity, and prior chemotherapy had significant correlations with time to tumor progression and survival.10 We combined 375 patients from eight phase II trials for analysis of outcomes and prognostic factors associated with recurrent GBM and recurrent AA.
|
PATIENTS AND METHODS
|
|---|
Patient Inclusion
Patients were drawn from eight consecutive phase II chemotherapy trials conducted at The University of Texas M.D. Anderson Cancer Center. From 1986 to 1995, seven trials using interferon beta (IFNß), IFNß combined with 13-cis-retinoic acid (CRA), menogaril, carboplatin, and a combination of carboplatin, fluorouracil (5-FU), and procarbazine were carried out at M.D. Anderson Cancer Center. One trial using difluoromethylornithine (DFMO) was carried out at M.D. Anderson Cancer Center and at the University of California, San Francisco. Menogaril, carboplatin, 5-FU, and procarbazine are known cytotoxic drugs, whereas IFNß, CRA, and DFMO are thought to be cytostatic agents that mediate antitumor effect by blocking cell growth without effecting cell kill. All trials were approved by the respective institutional review boards, and informed consent was obtained from each patient or guardian before enrollment.
Two trials administered intravenous IFNß at a dose of 90 million IU once daily on Mondays, Wednesdays, and Fridays. Another trial used IFNß at 6 or 18 million units daily on Mondays, Wednesdays, and Fridays, with or without CRA at 100 mg/m2/d. Menogaril was administered intravenously at a dose of 200 mg/m2 initially and was increased to 225 mg/m2 in subsequent cycles if tolerated; the drug was repeated every 4 weeks. DFMO was administered orally at a dose of 3.6 gm/m2 on days 1 to 14, 22 to 35, and 43 to 56; the cycle was repeated on day 63. Carboplatin was given intravenously at a dose of 400 mg/m2 initially and was increased to 475 and 525 mg/m2 if tolerated; the drug was repeated every 4 weeks. Two trials used a combination of carboplatin, 5-FU, and procarbazine. Carboplatin and 5-FU were given by continuous intravenous infusion at a daily dose of 75 mg/m2/d and at 1,000 mg/m2/d on days 1 to 4, respectively. Oral procarbazine was administered at a dose of 75 mg/m2/d for 10 days on days 5 to 14.
Patient eligibility and response criteria were similar among the trials. Briefly, patients with histologically identified malignant gliomas at recurrence were eligible for study. All eight studies required evidence of recurrence after prior radiotherapy and all had similar age criteria (eg, age > 16 years) and performance criteria (eg, KPS > 50). Each of the eight studies had a two-stage design (the first five were Gehan designs and the last three were Simon designs).8,11 Three studies were stopped after the first stage and enrolled fewer than 15 patients. Two studies were two-arm randomized phase II trials and three studies used separate strata for patients with and without previous chemotherapy. Although five of the eight studies did not restrict entry on the basis of previous chemotherapy, one trial excluded patients with any previous chemotherapy and two trials excluded patients with more than one previous chemotherapy regimen.
Patients enrolled onto the studies were evaluated by neurologic examinations and neuroimaging studies of the brain, contrast-enhanced computed tomography, gadolinium-enhanced magnetic resonance imaging, or both.12 Evaluations were performed at 2-month intervals during the first year, at 3-month intervals during the second year, at 4-month intervals during the third year, or until disease progression. Response to chemotherapy was assessed by radiographic criteria and extent of corticosteroid use. Complete response (CR) was defined as complete resolution of tumor as determined by neuroimaging studies with the patient on a stable dose of corticosteroid. Partial response (PR) consisted of a decrease in tumor volume by 50% or greater in the product of two diameters with no increase in corticosteroid dosage. Minor response (MR) involved a decrease in tumor size by less than 50% with stable or decreasing corticosteroid dose. Stable disease (SD) referred to no change in tumor size with stable or decreasing corticosteroid dose. Progressive disease was defined as definite worsening or development of a new lesion on imaging study with stable or increasing corticosteroid dose.
Patients who experienced medical complications, refused further participation in the study, developed toxicity, or died within 3 weeks of treatment were deemed nonassessable according to study protocols. To avoid postentry exclusion bias, these patients were included in our analysis. The response of those who suffered from an event at 3 weeks or later was based on the latest clinical and neuroimaging evaluations.
Three binary outcomes were defined: (1) CR or PR; (2) CR, PR, MR, or SD; and (3) alive and progression-free at 6 months (APF6). We also defined two time-to-event end points: progression-free survival (PFS) and overall survival (OS). Both were measured from the date of enrollment. PFS measures TTP or death, whichever occurs first. PFS at 6 months is equivalent to APF6.
Statistical Analysis
To evaluate the effects of prognostic factors on outcomes, odds ratios for the three binary end points were estimated with logistic regression,13 whereas hazard ratios for the two time-to-event end points were estimated using Cox regression.14 Both univariate and multivariate analyses were performed for each end point. PFS and OS curves were constructed using the Kaplan-Meier method,15 and estimates of medians and their respective 95% confidence intervals (CIs) were calculated from the Kaplan-Meier estimates. We also performed recursive partitioning in an attempt to identify prognostic subgroups. To perform the recursive partitioning analysis for censored data, we used the null martingale-based residual as input into the S-PLUS (MathSoft, Inc, Seattle, WA) implementation of tree-based methods.16,17 The assumptions of the regression analyses were verified with residual analyses.
Patient Characteristics
The eight chemotherapy trials accounted for a total of 458 enrollments. Eighty-three patients were excluded from analysis: 60 did not have GBM or AA (histologies included 18 mixed gliomas, 14 astrocytomas, 10 anaplastic oligodendrogliomas, eight oligodendrogliomas, five unclassified gliomas, three gliosarcomas, and two ependymomas), 18 AA or GBM patients were enrolled in more than one of the eight trials and only the first enrollment was counted, four patients were retrospectively judged to be ineligible for enrollment, and one patient had a KPS of 50. The histology and KPS exclusions were performed to increase patient homogeneity. A total of 375 unique patients remain for analysis.
The histologic diagnosis at the time of registration was recurrent GBM in 225 patients (60%) and recurrent AA in 150 patients (40%). The median age at enrollment was 45 years (range, 15 to 82 years). Six patients were younger than 20 years and five patients were older than 70. The median KPS at enrollment was 80 (range, 60 to 100). Twenty-two patients had KPS of 100 and 14 had KPS of 60. Two hundred eighty-five patients (77%) had received prior chemotherapy, whereas 92 patients (25%) had received at least two prior chemotherapy regimens. The maximum extent of previous surgery was biopsy in 46 patients (12%), partial resection in 194 patients (52%), and gross total resection in 135 patients (36%). One hundred twenty-eight patients (34%) had two prior surgeries, whereas 27 patients (7%) had more than two prior surgeries. We do not have data on the number of previous recurrences (ie, progressions), but this should be reflected in the number of previous chemotherapy regimens. Furthermore, although it is straight forward to determine whether a patient had prior chemotherapy, the lack of standardized diagnostic criteria make the determination of prior progression problematic. To separate out heavily pretreated (salvage) patients, we identified 41 patients with more than two prior chemotherapies and/or more than two prior surgeries.
|
RESULTS
|
|---|
Outcomes
Among the 375 patients, 34 (9%) experienced CR (n=1) or PR (n=33), 18 (5%) experienced MR, and 94 (25%) experienced SD. Thus a total of 146 (39%) experienced CR, PR, MR, or SD. A total of 80 (21%) were alive and progression-free at 6 months (ie, the overall APF6 was 21%). The 95% CI for APF6 was 17% to 26%. A total of 343 patients experienced a progression of disease by the end of the study and a total of 298 patients had died by the end of the study. Fifty-nine patients were alive after progression and 14 patients died without radiographic evidence of progression (although most died from their brain cancer). These 14 patients constitute the difference between freedom from progression (in which case these patients would be censored and not count as events) and progression-free survival (in which case these patients are included as events). Thus our results for PFS would be similar to results using freedom from progression (357 events v 343 events). Eighteen patients were alive without progression with a median follow-up of 5.1 years (range, 35 weeks to 8.1 years). Nine patients with best protocol response of CR or PR had disease progression by 6 months after enrollment.
The median OS time in the total patient group was 30 weeks, 6-month survival proportion was 55%, 1-year survival proportion was 32%, and 5-year survival proportion was 10%. The 95% CI for median OS time was 26 to 35 weeks. The median PFS time was 10 weeks, 6-month PFS proportion was 21%, 1-year PFS proportion was 12% and 5-year PFS proportion was 4%. The 95% CI for the median PFS time was 9 to 11 weeks. Figure 1 shows the OS and PFS curves for the 375 patients. Seventy-nine percent of patients had failed by 26 weeks, and 26 weeks marks the beginning of the long tail in the PFS curve shown in Fig 1. This suggests that 26 weeks would be a convenient time point to capture most of the failures (hence our use of AFP6).
View larger version (17K):
[in this window]
[in a new window]
|
Fig 1. OS and PFS in 375 patients. OS is 55%, 32%, and 10% at 26, 52, and 260 weeks, respectively; PFS is 21%, 12%, and 4% at 26, 52, and 260 weeks, respectively.
|
|
Prognostic Factors
Table 1 shows the five outcomes according to the levels of the four covariates (histology, age  40 years, KPS > 80, and salvage therapy). As listed in Tables 1 and 2, for all five outcomes, GBM patients had significantly poorer outcomes as compared with AA patients. APF6 was 15% for GBM (95% CI, 10% to 19%) and 31% for AA (95% CI, 24% to 39%). Figure 2 shows PFS curves according to histology. The 5-year OS proportion was 2% for GBM and 21% for AA. The median PFS time was 9 weeks for GBM (95% CI, 8 to 10 weeks) and 13 weeks for AA (95% CI, 10 to 18 weeks). The median OS time was 25 weeks for GBM (95% CI, 21 to 28 weeks) and 47 weeks for AA (95% CI, 38 to 64 weeks).
View larger version (17K):
[in this window]
[in a new window]
|
Fig 2. PFS according to histology in 375 patients. PFS is 31%, 20%, and 10% at 26, 52, and 104 weeks, respectively, for AA patients, and 15%, 8%, and 4% at 26, 52, and 104 weeks, respectively, for GBM patients.
|
|
Table 3 shows the multivariate results for the five end points. Histology remains a significant predictor for all end points. Salvage treatment is significantly associated with poorer outcome for four of the five end points (the CR/PR analysis lacks adequate statistical power). KPS was significantly associated with survival only, whereas age was not related to outcome. The results for age and KPS were similar when these variables were analyzed as continuous covariates.
We decided to use a "salvage" treatment dichotomy to summarize the previous treatment data because our data indicated that patients with fewer than three prior surgeries and fewer than three prior chemotherapies had similar responses regardless of the actual number of surgeries or chemotherapies. For example, among patients with only one prior surgery, the 48 patients with no prior chemotherapy had a 29% APF6, the 121 patients with one prior chemotherapy had a 20% APF6, and the 41 patients with two prior chemotherapies had a 24% APF6. Similarly, among patients with two prior surgeries, the 31 with no prior chemotherapy had a 23% APF6, the 63 with one prior chemotherapy had a 24% APF6, and the 28 with two prior chemotherapies had a 21% APF6. Thus, the 332 patients with no more than two prior chemotherapies and no more than two prior surgeries had an aggregate 23% APF6 proportion, compared with 10% for the 41 patients with more than two prior surgeries or more than two prior chemotherapies (ie, our salvage treatment patients).
Additional analyses were performed to compare the effects of cytotoxic and cytostatic chemotherapies in our cohort. No statistical differences in outcomes were found between the patients treated with cytotoxic agents and those treated with cytostatic agents. For example, 21 (21%) of 102 patients who received cytotoxic agents were alive and progression-free at 6 months compared with 59 (22%) of the 273 patients who received cytostatic agents (odds ratio = 0.9, 95% CI, 0.5 to 1.6, P = .80).
Recursive partitioning analysis confirmed the prognostic importance of histology. Histology was the first split for all five end points. Within the AA subgroup, recursive partitioning identified 119 patients with a KPS greater than 70 as having favorable long-term outcomes: median PFS time of 15 weeks compared with 9 weeks for 31 AA patients with a KPS of less than or equal to 70 (P = .0090); median OS time of 59 weeks compared with 20 weeks (P = .0002). No further meaningful prognostic subgroups were identified. We used a KPS of greater than 80 for our analyses because the results were similar to those obtained with using a KPS more than 70, because 85 was selected by recursive partitioning as the optimal cutoff for all five endpoints, and because a KPS greater than 80 yielded a more even split of the data, thus providing more precise effect estimates. We used an age cutoff of 40 years as a compromise between the optimal cutoffs for the five end points (which ranged from 28 to 52 years). We also chose 40 because it was close to the optimal cutoff for APF6 (41.5) and to the median age (45).
|
DISCUSSION
|
|---|
The entry criteria for these phase II studies are similar to those generally used for recurrent glioma. Thus, the results from our historical database should apply to patients eligible for such studies. The restrictions applied to histology, age, performance status, and (in some cases) prior chemotherapy should have some affect on the apparent relationships between these factors and prognosis. Different results might be obtained if patients with additional histologies, younger ages, and lower performance status were included. In particular, the apparent effects of age and performance status would presumably be larger in a less restricted setting. Although the entry criteria for the studies included in our analysis were similar, they were not identical and this heterogeneity is a potential weakness of our study.
Our results demonstrate the clear differences in outcomes between recurrent AA and recurrent GBM patients. Patients with GBM histology did consistently worse than patients with AA across all measures with respect to tumor response, progression, and survival. It seems clear that future trials should report results separately for AA and GBM. Ideally future trials would be designed with separate strata for AA and GBM. Furthermore, the relevance of the overall results of this historical database depends on future trials having roughly 60% GBM.
Among prognostic factors examined in our study, histology was a highly significant prognostic variable for recurrent malignant gliomas. To a lesser extent, a KPS greater than 80 and salvage treatment were associated with poorer outcomes. A high KPS is expected to associate with a favorable outcome because it is probably a marker for overall tumor burden, cumulative treatment-related toxicity, or both.18,19
A similar study reported more than a decade ago by Eagan and Scott9 showed that none of their six factors examined, age, sex, tumor grade, performance score, TTP after irradiation, and prior chemotherapies, correlated with response or TTP. Performance score was the only variable correlated with survival. Our study had 375 patients combined from eight phase II trials, and this number would have enough statistical power to detect small differences in our prognostic variables (except perhaps for CR/PR where only 34 events were observed). This strategy of combining data from multiple small trials is similar to a meta-analysis, as in the one that established chemotherapy efficacy in newly diagnosed GBM and AA20 even though multiple small trials had failed to do so previously. But unlike a typical meta-analysis, our trials were all performed at a single institution with similar entry criteria and methods of follow-up. This feature helps to minimize the extent of heterogeneity in our data. In addition, contrary to the study by Eagan and Scott, a large number of our patients had chemotherapies, and chemotherapy may accentuate small differences between GBM and AA. Nevertheless, the paucity of prognostic factors in recurrent malignant gliomas suggests that current treatments are still inadequate and much effort will be needed to develop better treatment strategies.
Because our study included trials using cytotoxic and cytostatic agents, we performed an analysis to see whether patient outcome depends on the type of agents used. We found little difference in outcome. This result provides an important basis to combine the eight phase II trials in our study, and further suggests that recurrent malignant gliomas are relatively resistant to current second-line therapies, regardless of cytotoxic or cytostatic agents.
In addition to prognostic factors, we established a set of reference outcome parameters, with respect to response, tumor progression, and survival, that can be used in future clinical trials for recurrent malignant gliomas. Although response to therapy remains a gold standard in current clinical trials for brain tumors,21 PFS may play an increasingly important role in future studies. This is because emerging cytostatic drugs, such as biologic response modifiers22 and antiangiogenic drugs,23 are expected to stabilize tumor growth and would not effect tumor cell kill. As a result, a large number of patients would have SD, and cytostatic drugs would make an impact on patient outcome if their tumors remain stable for a significant period of time. Likewise, although survival is a frequently used end point in clinical trials,24 PFS could be an alternative measure of treatment efficacy and would help validate response and survival data. APF6 is especially convenient because binary end points are easier to use for phase II trials. A major criticism for using survival as an end point is the multiplicity of treatments received by patients during the course of their illness. Separating out the effect on survival of a particular treatment in a study from other treatment effects would be difficult but not impossible. Furthermore, as evidenced by the steep slopes and long tails in the Kaplan-Meier PFS and survival curves (Fig 1), current treatments benefit only a small number of patients with recurrent malignant gliomas.
|
ACKNOWLEDGMENTS
|
|---|
Supported by National Cancer Institute grants no. CA55621, CA62412 and CA62431.
We thank Sandra Ictech, Brian Petter, and Mary Malec for help in data collection and Lissa Lawhorn for secretarial assistance.
|
NOTES
|
|---|
Presented in part at the Thirty-Second Annual Meeting of the American Society of Clinical Oncology, Philadelphia, PA, May 18-21, 1996.
|
REFERENCES
|
|---|
1.
Burger PC, Vogel FS, Green SB, et al: Glioblastoma multiforme and anaplastic astrocytoma, pathologic criteria and prognostic implications. Cancer56:1106-1111, 1985[Medline]
2.
Rosenblum ML, Gerosa M, Dougherty DV, et al: Age-related chemosensitivity of stem cells from human malignant brain tumors. Lancet1:885-887, 1982[Medline]
3.
Grant R, Liang BC, Page MA, et al: Age influences chemotherapy response in astrocytomas. Neurology45:929-933, 1995[Abstract/Free Full Text]
4.
Nelson JS, Tsukada Y, Schoenfeld D, et al: Necrosis as a prognostic criterion in malignant supratentorial, astrocytic gliomas. Cancer52:550-554, 1983[Medline]
5.
SC Schold, Jr, Burger PC, Mendelsohn DB, et al: Primary Tumors of the Brain and Spinal Cord. Boston, MA, Butterworth-Heinemann, 1997, pp 51-54
6.
Wood JR, Green SB, Shapiro WR, et al: The prognostic importance of tumor size in malignant gliomas: A computed tomographic scan study by the Brain Tumor Cooperative Group. J Clin Oncol6:338-343, 1988[Abstract]
7.
Walker MD, Green SB, Byar DP, et al: Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med303:1323-1329, 1989[Abstract]
8.
Gehan EA: The determination of the number of patients required in a preliminary and follow-up trial of a new chemotherapeutic agent. J Chronic Dis13:346-353, 1961[Medline]
9.
Eagan RT, Scott M: Evaluation of prognostic factors in chemotherapy of recurrent brain tumors. J Clin Oncol1:38-44, 1983[Abstract]
10.
Rostomily RC, Spence AM, Duong D, et al: Multimodality management of recurrent adult malignant gliomas: Results of a phase II multiagent chemotherapy study and analysis of cytoreductive surgery. Neurosurgery35:378-388, 1994[Medline]
11.
Simon R: Optimal two-stage designs for phase II clinical trials. Control Clin Trials10:1-10, 1989[Medline]
12.
Levin VA, Wilson CB, Craft D, et al: Criteria for evaluating malignant brain tumor patients undergoing chemotherapy. J Neurosurg47:329-335, 1977[Medline]
13.
Collett D: Modelling of Binary Data. New York, NY, Chapman and Hall, 1992
14.
Cox DR, Oakes D: Analysis of Survival Data. New York, NY, Chapman and Hall, 1984
15.
Kaplan EL, Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc53:475-481, 1958
16.
Clark LA, Pregibon D: Tree-based models, in Chambers JM, Hastie JJ (eds): Statistical Models in S. Belmont, CA, Wadsworth, 1992, pp 377-419
17.
Therneau T, Grambsch P, Fleming T: Martingale based residuals for survival models. Biometrika77:147-160, 1990[Abstract/Free Full Text]
18.
Salcman M: Resection and reoperation in neuro-oncology: Rationale and approach. Neurol Clin3:831-842, 1985[Medline]
19.
Levin VA, Prados MD: Treatment of recurrent gliomas and metastatic brain tumors with a polydrug protocol designed to combat nitrosourea resistance. J Clin Oncol10:766-771, 1992[Abstract/Free Full Text]
20.
Fine HA, Dear KBG, Loeffler JS, et al: Meta-analysis of radiation therapy with and without adjuvant chemotherapy for malignant gliomas in adults. Cancer71:2585-2597, 1993[Medline]
21.
MacDonald DR, Cascino TL, Schold SC, et al: Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol8:1277-1280, 1990[Abstract]
22.
Yung WKA, Steck PA, Kelleher PJ, et al: Growth inhibitory effect of recombinant alpha and beta interferon on human glioma cells. J Neurooncol5:323-330, 1987[Medline]
23.
Taki T, Ohnishi T, Arita N, et al: Anti-proliferative effects of TNP-470 on human malignant glioma in vivo: Potent inhibition of tumor angiogenesis. J Neurooncol19:251-258, 1994[Medline]
24.
Bajan B, Ross G, Lim CC, et al: Survival in patients with recurrent glioma as a measure of treatment efficacy: Prognostic factors following nitrosourea chemotherapy. Eur J Cancer12:1809-1815, 1994
Submitted May 11, 1998;
accepted March 19, 1999.
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Facebook  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
F. M. Iwamoto, L. E. Abrey, K. Beal, P. H. Gutin, M. K. Rosenblum, V. E. Reuter, L. M. DeAngelis, and A. B. Lassman
Patterns of relapse and prognosis after bevacizumab failure in recurrent glioblastoma
Neurology,
October 13, 2009;
73(15):
1200 - 1206.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. S. Friedman, M. D. Prados, P. Y. Wen, T. Mikkelsen, D. Schiff, L. E. Abrey, W.K. A. Yung, N. Paleologos, M. K. Nicholas, R. Jensen, et al.
Bevacizumab Alone and in Combination With Irinotecan in Recurrent Glioblastoma
J. Clin. Oncol.,
October 1, 2009;
27(28):
4733 - 4740.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Karpel-Massler, U. Schmidt, A. Unterberg, and M.-E. Halatsch
Therapeutic Inhibition of the Epidermal Growth Factor Receptor in High-Grade Gliomas: Where Do We Stand?
Mol. Cancer Res.,
July 1, 2009;
7(7):
1000 - 1012.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J. van den Bent, M. A. Vogelbaum, P. Y. Wen, D. R. Macdonald, and S. M. Chang
End Point Assessment in Gliomas: Novel Treatments Limit Usefulness of Classical Macdonald's Criteria
J. Clin. Oncol.,
June 20, 2009;
27(18):
2905 - 2908.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. Chi, A. G. Sorensen, R. K. Jain, and T. T. Batchelor
Angiogenesis as a Therapeutic Target in Malignant Gliomas
Oncologist,
June 1, 2009;
14(6):
621 - 636.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Stupp, F. Roila, and On behalf of the ESMO Guidelines Working Group
Malignant glioma: ESMO Clinical Recommendations for diagnosis, treatment and follow-up
Ann. Onc.,
May 1, 2009;
20(suppl_4):
iv126 - iv128.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. C. Chamberlain
Cilengitide: Does It Really Represent a New Targeted Therapy for Recurrent Glioblastoma?
J. Clin. Oncol.,
April 10, 2009;
27(11):
1921 - 1921.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Reardon
In Reply
J. Clin. Oncol.,
April 10, 2009;
27(11):
1922 - 1922.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. L. Nghiemphu, W. Liu, Y. Lee, T. Than, C. Graham, A. Lai, R. M. Green, W. B. Pope, L. M. Liau, P. S. Mischel, et al.
Bevacizumab and chemotherapy for recurrent glioblastoma: A single-institution experience
Neurology,
April 7, 2009;
72(14):
1217 - 1222.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. N. Kreisl, L. Kim, K. Moore, P. Duic, C. Royce, I. Stroud, N. Garren, M. Mackey, J. A. Butman, K. Camphausen, et al.
Phase II Trial of Single-Agent Bevacizumab Followed by Bevacizumab Plus Irinotecan at Tumor Progression in Recurrent Glioblastoma
J. Clin. Oncol.,
February 10, 2009;
27(5):
740 - 745.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. D. Norden, J. Drappatz, A. S. Ciampa, L. Doherty, D. C. LaFrankie, S. Kesari, and P. Y. Wen
Colon perforation during antiangiogenic therapy for malignant glioma
Neuro-oncol,
January 1, 2009;
11(1):
92 - 95.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. C. Quant, A. D. Norden, J. Drappatz, A. Muzikansky, L. Doherty, D. LaFrankie, A. Ciampa, S. Kesari, and P. Y. Wen
Role of a second chemotherapy in recurrent malignant glioma patients who progress on bevacizumab
Neuro-oncol,
January 1, 2009;
11(5):
550 - 555.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. M. Chang, J. Clarke, and P. Wen
Novel Imaging Response Assessment for Drug Therapies in Recurrent Malignant Glioma
ASCO Educational Book,
January 1, 2009;
2009(1):
107 - 111.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Y. Wen, A. D. Norden, and J. Drappatz
Antiangiogenic Therapies for Malignant Gliomas
ASCO Educational Book,
January 1, 2009;
2009(1):
113 - 117.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Desjardins, D. A. Reardon, J. E. Herndon II, J. Marcello, J. A. Quinn, J. N. Rich, S. Sathornsumetee, S. Gururangan, J. Sampson, L. Bailey, et al.
Bevacizumab Plus Irinotecan in Recurrent WHO Grade 3 Malignant Gliomas
Clin. Cancer Res.,
November 1, 2008;
14(21):
7068 - 7073.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Raymond, A. A. Brandes, C. Dittrich, P. Fumoleau, B. Coudert, P. M.J. Clement, M. Frenay, R. Rampling, R. Stupp, J. M. Kros, et al.
Phase II Study of Imatinib in Patients With Recurrent Gliomas of Various Histologies: A European Organisation for Research and Treatment of Cancer Brain Tumor Group Study
J. Clin. Oncol.,
October 1, 2008;
26(28):
4659 - 4665.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Idbaih, F. Ducray, M. Sierra Del Rio, K. Hoang-Xuan, and J.-Y. Delattre
Therapeutic Application of Noncytotoxic Molecular Targeted Therapy in Gliomas: Growth Factor Receptors and Angiogenesis Inhibitors
Oncologist,
September 1, 2008;
13(9):
978 - 992.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Phuphanich, K. A. Carson, S. A. Grossman, G. Lesser, J. Olson, T. Mikkelsen, S. Desideri, J. D. Fisher, and for the New Approaches to Brain Tumor Therapy (NAB
Phase I safety study of escalating doses of atrasentan in adults with recurrent malignant glioma
Neuro-oncol,
August 1, 2008;
10(4):
617 - 623.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. M. Chang, K. R. Lamborn, J. G. Kuhn, W.K. A. Yung, M. R. Gilbert, P. Y. Wen, H. A. Fine, M. P. Mehta, L. M. DeAngelis, F. S. Lieberman, et al.
Neurooncology clinical trial design for targeted therapies: Lessons learned from the North American Brain Tumor Consortium
Neuro-oncol,
August 1, 2008;
10(4):
631 - 642.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Y. Wen and S. Kesari
Malignant Gliomas in Adults
N. Engl. J. Med.,
July 31, 2008;
359(5):
492 - 507.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Reardon, M. R. Zalutsky, G. Akabani, R. E. Coleman, A. H. Friedman, J. E. Herndon II, R. E. McLendon, C. N. Pegram, J. A. Quinn, J. N. Rich, et al.
A pilot study: 131I-Antitenascin monoclonal antibody 81c6 to deliver a 44-Gy resection cavity boost
Neuro-oncol,
April 1, 2008;
10(2):
182 - 189.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. K. Puduvalli, P. Giglio, M. D. Groves, K. R. Hess, M. R. Gilbert, S. Mahankali, E. F. Jackson, V. A. Levin, C. A. Conrad, S. H. Hsu, et al.
Phase II trial of irinotecan and thalidomide in adults with recurrent glioblastoma multiforme
Neuro-oncol,
April 1, 2008;
10(2):
216 - 222.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. R. Lamborn, W. K. A. Yung, S. M. Chang, P. Y. Wen, T. F. Cloughesy, L. M. DeAngelis, H. I. Robins, F. S. Lieberman, H. A. Fine, K. L. Fink, et al.
Progression-free survival: An important end point in evaluating therapy for recurrent high-grade gliomas
Neuro-oncol,
April 1, 2008;
10(2):
162 - 170.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. D. Norden, G. S. Young, K. Setayesh, A. Muzikansky, R. Klufas, G. L. Ross, A. S. Ciampa, L. G. Ebbeling, B. Levy, J. Drappatz, et al.
Bevacizumab for recurrent malignant gliomas: Efficacy, toxicity, and patterns of recurrence
Neurology,
March 4, 2008;
70(10):
779 - 787.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Sathornsumetee, Y. Cao, J. E. Marcello, J. E. Herndon II, R. E. McLendon, A. Desjardins, H. S. Friedman, M. W. Dewhirst, J. J. Vredenburgh, and J. N. Rich
Tumor Angiogenic and Hypoxic Profiles Predict Radiographic Response and Survival in Malignant Astrocytoma Patients Treated With Bevacizumab and Irinotecan
J. Clin. Oncol.,
January 10, 2008;
26(2):
271 - 278.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. R. Zalutsky, D. A. Reardon, G. Akabani, R. E. Coleman, A. H. Friedman, H. S. Friedman, R. E. McLendon, T. Z. Wong, and D. D. Bigner
Clinical Experience with {alpha}-Particle Emitting 211At: Treatment of Recurrent Brain Tumor Patients with 211At-Labeled Chimeric Antitenascin Monoclonal Antibody 81C6
J. Nucl. Med.,
January 1, 2008;
49(1):
30 - 38.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. A. Fine, L. Kim, P. S. Albert, J. P. Duic, H. Ma, W. Zhang, T. Tohnya, W. D. Figg, and C. Royce
A Phase I Trial of Lenalidomide in Patients with Recurrent Primary Central Nervous System Tumors
Clin. Cancer Res.,
December 1, 2007;
13(23):
7101 - 7106.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. B. Furnari, T. Fenton, R. M. Bachoo, A. Mukasa, J. M. Stommel, A. Stegh, W. C. Hahn, K. L. Ligon, D. N. Louis, C. Brennan, et al.
Malignant astrocytic glioma: genetics, biology, and paths to treatment
Genes & Dev.,
November 1, 2007;
21(21):
2683 - 2710.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. T. Wong and S. Brem
Taming Glioblastoma: Targeting Angiogenesis
J. Clin. Oncol.,
October 20, 2007;
25(30):
4705 - 4706.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. J. Vredenburgh, A. Desjardins, J. E. Herndon II, J. Marcello, D. A. Reardon, J. A. Quinn, J. N. Rich, S. Sathornsumetee, S. Gururangan, J. Sampson, et al.
Bevacizumab Plus Irinotecan in Recurrent Glioblastoma Multiforme
J. Clin. Oncol.,
October 20, 2007;
25(30):
4722 - 4729.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. E. Wohlfahrt, B. C. Beard, A. Lieber, and H.-P. Kiem
A Capsid-Modified, Conditionally Replicating Oncolytic Adenovirus Vector Expressing TRAIL Leads to Enhanced Cancer Cell Killing in Human Glioblastoma Models
Cancer Res.,
September 15, 2007;
67(18):
8783 - 8790.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Wick, J. Felsberg, J. P. Steinbach, U. Herrlinger, M. Platten, B. Blaschke, R. Meyermann, G. Reifenberger, M. Weller, and W. Wick
Efficacy and Tolerability of Temozolomide in an Alternating Weekly Regimen in Patients With Recurrent Glioma
J. Clin. Oncol.,
August 1, 2007;
25(22):
3357 - 3361.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Kesari, D. Schiff, L. Doherty, D. C. Gigas, T. T. Batchelor, A. Muzikansky, A. O'Neill, J. Drappatz, A. S. Chen-Plotkin, N. Ramakrishna, et al.
Phase II study of metronomic chemotherapy for recurrent malignant gliomas in adults
Neuro-oncol,
July 1, 2007;
9(3):
354 - 363.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M.P. Omuro, S. Faivre, and E. Raymond
Lessons learned in the development of targeted therapy for malignant gliomas
Mol. Cancer Ther.,
July 1, 2007;
6(7):
1909 - 1919.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. A. Carson, S. A. Grossman, J. D. Fisher, and E. G. Shaw
Prognostic Factors for Survival in Adult Patients With Recurrent Glioma Enrolled Onto the New Approaches to Brain Tumor Therapy CNS Consortium Phase I and II Clinical Trials
J. Clin. Oncol.,
June 20, 2007;
25(18):
2601 - 2606.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. D. Kirson, V. Dbaly, F. Tovarys, J. Vymazal, J. F. Soustiel, A. Itzhaki, D. Mordechovich, S. Steinberg-Shapira, Z. Gurvich, R. Schneiderman, et al.
Alternating electric fields arrest cell proliferation in animal tumor models and human brain tumors
PNAS,
June 12, 2007;
104(24):
10152 - 10157.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Kunwar, M. D. Prados, S. M. Chang, M. S. Berger, F. F. Lang, J. M. Piepmeier, J. H. Sampson, Z. Ram, P. H. Gutin, R. D. Gibbons, et al.
Direct Intracerebral Delivery of Cintredekin Besudotox (IL13-PE38QQR) in Recurrent Malignant Glioma: A Report by the Cintredekin Besudotox Intraparenchymal Study Group
J. Clin. Oncol.,
March 1, 2007;
25(7):
837 - 844.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Hau, D. Koch, T. Hundsberger, E. Marg, B. Bauer, R. Rudolph, M. Rauch, A. Brenner, P. Rieckmann, J. Schuth, et al.
Safety and feasibility of long-term temozolomide treatment in patients with high-grade glioma
Neurology,
February 27, 2007;
68(9):
688 - 690.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. J. Vredenburgh, A. Desjardins, J. E. Herndon II, J. M. Dowell, D. A. Reardon, J. A. Quinn, J. N. Rich, S. Sathornsumetee, S. Gururangan, M. Wagner, et al.
Phase II Trial of Bevacizumab and Irinotecan in Recurrent Malignant Glioma
Clin. Cancer Res.,
February 15, 2007;
13(4):
1253 - 1259.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. C. Chamberlain, W. B. Pope, and T. Cloughesy
MRI in patients with high-grade gliomas treated with bevacizumab and chemotherapy
Neurology,
December 12, 2006;
67(11):
2089 - 2089.
[Full Text]
[PDF]
|
|
|
|
|
|
|
U. Herrlinger, J. Rieger, D. Koch, S. Loeser, B. Blaschke, R.-D. Kortmann, J. P. Steinbach, T. Hundsberger, W. Wick, R. Meyermann, et al.
Phase II Trial of Lomustine Plus Temozolomide Chemotherapy in Addition to Radiotherapy in Newly Diagnosed Glioblastoma: UKT-03
J. Clin. Oncol.,
September 20, 2006;
24(27):
4412 - 4417.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Y. Wen, W.K. A. Yung, K. R. Lamborn, P. L. Dahia, Y. Wang, B. Peng, L. E. Abrey, J. Raizer, T. F. Cloughesy, K. Fink, et al.
Phase I/II Study of Imatinib Mesylate for Recurrent Malignant Gliomas: North American Brain Tumor Consortium Study 99-08.
Clin. Cancer Res.,
August 15, 2006;
12(16):
4899 - 4907.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Doherty, D. C. Gigas, S. Kesari, J. Drappatz, R. Kim, J. Zimmerman, L. Ostrowsky, and P. Y. Wen
Pilot study of the combination of EGFR and mTOR inhibitors in recurrent malignant gliomas.
Neurology,
July 11, 2006;
67(1):
156 - 158.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Payner, H. A. Leaver, B. Knapp, I. R. Whittle, O. C. Trifan, S. Miller, and M. T. Rizzo
Microsomal prostaglandin E synthase-1 regulates human glioma cell growth via prostaglandin E2-dependent activation of type II protein kinase A.
Mol. Cancer Ther.,
July 1, 2006;
5(7):
1817 - 1826.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Reardon, J. A. Quinn, G. Akabani, R. E. Coleman, A. H. Friedman, H. S. Friedman, J. E. Herndon II, R. E. McLendon, C. N. Pegram, J. M. Provenzale, et al.
Novel Human IgG2b/Murine Chimeric Antitenascin Monoclonal Antibody Construct Radiolabeled with 131I and Administered into the Surgically Created Resection Cavity of Patients with Malignant Glioma: Phase I Trial Results
J. Nucl. Med.,
June 1, 2006;
47(6):
912 - 918.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Schmidt, J. Fischer, U. Herrlinger, K. Dietz, J. Dichgans, and M. Weller
PCV chemotherapy for recurrent glioblastoma
Neurology,
February 28, 2006;
66(4):
587 - 589.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Reardon, J. A. Quinn, J. J. Vredenburgh, S. Gururangan, A. H. Friedman, A. Desjardins, S. Sathornsumetee, J. E. Herndon II, J. M. Dowell, R. E. McLendon, et al.
Phase 1 Trial of Gefitinib Plus Sirolimus in Adults with Recurrent Malignant Glioma
Clin. Cancer Res.,
February 1, 2006;
12(3):
860 - 868.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Stupp, M. E. Hegi, M. J. van den Bent, W. P. Mason, M. Weller, R. O. Mirimanoff, J. G. Cairncross, and on behalf of the European Organisation for Researc
Changing paradigms--an update on the multidisciplinary management of malignant glioma.
Oncologist,
February 1, 2006;
11(2):
165 - 180.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. D. Prados, K. R. Lamborn, S. Chang, E. Burton, N. Butowski, M. Malec, A. Kapadia, J. Rabbitt, M. S. Page, A. Fedoroff, et al.
Phase 1 study of erlotinib HCl alone and combined with temozolomide in patients with stable or recurrent malignant glioma
Neuro-oncol,
January 1, 2006;
8(1):
67 - 78.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Reardon, G. Akabani, R. E. Coleman, A. H. Friedman, H. S. Friedman, J. E. Herndon II, R. E. McLendon, C. N. Pegram, J. M. Provenzale, J. A. Quinn, et al.
Salvage Radioimmunotherapy With Murine Iodine-131-Labeled Antitenascin Monoclonal Antibody 81C6 for Patients With Recurrent Primary and Metastatic Malignant Brain Tumors: Phase II Study Results
J. Clin. Oncol.,
January 1, 2006;
24(1):
115 - 122.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Ferrari, M. Cremonesi, M. Bartolomei, L. Bodei, M. Chinol, M. Fiorenza, G. Tosi, and G. Paganelli
Dosimetric Model for Locoregional Treatments of Brain Tumors with 90Y-Conjugates: Clinical Application with 90Y-DOTATOC
J. Nucl. Med.,
January 1, 2006;
47(1):
105 - 112.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Reardon, M. J. Egorin, J. A. Quinn, J. N. Rich Sr, I. Gururangan, J. J. Vredenburgh, A. Desjardins, S. Sathornsumetee, J. M. Provenzale, J. E. Herndon II, et al.
Phase II Study of Imatinib Mesylate Plus Hydroxyurea in Adults With Recurrent Glioblastoma Multiforme
J. Clin. Oncol.,
December 20, 2005;
23(36):
9359 - 9368.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. M. Chang, S. L. Reynolds, N. Butowski, K. R. Lamborn, J. C. Buckner, R. S. Kaplan, and D. D. Bigner
GNOSIS: Guidelines for neuro-oncology: Standards for investigational studies--reporting of phase 1 and phase 2 clinical trials
Neuro-oncol,
October 1, 2005;
7(4):
425 - 434.
[Abstract]
[PDF]
|
|
|
|
|
|
|
G. Dresemann
Imatinib and hydroxyurea in pretreated progressive glioblastoma multiforme: a patient series
Ann. Onc.,
October 1, 2005;
16(10):
1702 - 1708.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. F. Cloughesy, J. Kuhn, H. I. Robins, L. Abrey, P. Wen, K. Fink, F. S. Lieberman, M. Mehta, S. Chang, A. Yung, et al.
Phase I Trial of Tipifarnib in Patients With Recurrent Malignant Glioma Taking Enzyme-Inducing Antiepileptic Drugs: A North American Brain Tumor Consortium Study
J. Clin. Oncol.,
September 20, 2005;
23(27):
6647 - 6656.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-B. Wasserfallen, S. Ostermann, S. Leyvraz, and R. Stupp
Cost of temozolomide therapy and global care for recurrent malignant gliomas followed until death
Neuro-oncol,
April 1, 2005;
7(2):
189 - 195.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. F. Dempsey, B. R. Condon, and D. M. Hadley
Measurement of Tumor "Size" in Recurrent Malignant Glioma: 1D, 2D, or 3D?
AJNR Am. J. Neuroradiol.,
April 1, 2005;
26(4):
770 - 776.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. H. Sampson, D. A. Reardon, A. H. Friedman, H. S. Friedman, R. E. Coleman, R. E. McLendon, I. Pastan, and D. D. Bigner
Sustained radiographic and clinical response in patient with bifrontal recurrent glioblastoma multiforme with intracerebral infusion of the recombinant targeted toxin TP-38: Case study
Neuro-oncol,
January 1, 2005;
7(1):
90 - 96.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. R. Zalutsky
Current Status of Therapy of Solid Tumors: Brain Tumor Therapy
J. Nucl. Med.,
January 1, 2005;
46(1_suppl):
151S - 156S.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. A. Brandes, A. Tosoni, U. Basso, M. Reni, F. Valduga, S. Monfardini, P. Amista, L. Nicolardi, G. Sotti, and M. Ermani
Second-Line Chemotherapy With Irinotecan Plus Carmustine in Glioblastoma Recurrent or Progressive After First-Line Temozolomide Chemotherapy: A Phase II Study of the Gruppo Italiano Cooperativo di Neuro-Oncologia (GICNO)
J. Clin. Oncol.,
December 1, 2004;
22(23):
4779 - 4786.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
V. K. Puduvalli, W.K. A. Yung, K. R. Hess, J. G. Kuhn, M. D. Groves, V. A. Levin, J. Zwiebel, S. M. Chang, T. F. Cloughesy, L. Junck, et al.
Phase II Study of Fenretinide (NSC 374551) in Adults With Recurrent Malignant Gliomas: A North American Brain Tumor Consortium Study
J. Clin. Oncol.,
November 1, 2004;
22(21):
4282 - 4289.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. A. Brandes, A. Tosoni, P. Amista, L. Nicolardi, D. Grosso, F. Berti, and M. Ermani
How effective is BCNU in recurrent glioblastoma in the modern era?: A phase II trial
Neurology,
October 12, 2004;
63(7):
1281 - 1284.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Wick, J. P. Steinbach, W. M. Kuker, J. Dichgans, M. Bamberg, and M. Weller
One week on/one week off: A novel active regimen of temozolomide for recurrent glioblastoma
Neurology,
June 8, 2004;
62(11):
2113 - 2115.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. A. Brandes, U. Basso, M. Reni, F. Vastola, A. Tosoni, G. Cavallo, L. Scopece, A. J. Ferreri, M. G. Panucci, S. Monfardini, et al.
First-Line Chemotherapy With Cisplatin Plus Fractionated Temozolomide in Recurrent Glioblastoma Multiforme: A Phase II Study of the Gruppo Italiano Cooperativo di Neuro-Oncologia
J. Clin. Oncol.,
May 1, 2004;
22(9):
1598 - 1604.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Reardon, J. A. Quinn, J. N. Rich, S. Gururangan, J. Vredenburgh, J. H. Sampson, J. M. Provenzale, A. Walker, M. Badruddoja, S. Tourt-Uhlig, et al.
Phase 2 trial of BCNU plus irinotecan in adults with malignant glioma
Neuro-oncol,
April 1, 2004;
6(2):
134 - 144.
[Abstract]
[PDF]
|
|
|
|
|
|
|
R. J. Weil
Potential Confounding Features in p53 Gene Therapy of Recurrent Glioma
J. Clin. Oncol.,
April 1, 2004;
22(7):
1344 - 1345.
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. F. Lang and W.K. Alfred Yung
In Reply:
J. Clin. Oncol.,
April 1, 2004;
22(7):
1345 - 1345.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. D. Prados, W.K. A. Yung, H. A. Fine, H. S. Greenberg, L. Junck, S. M. Chang, M. K. Nicholas, H. I. Robins, M. P. Mehta, K. L. Fink, et al.
Phase 2 study of BCNU and temozolomide for recurrent glioblastoma multiforme: North American Brain Tumor Consortium study
Neuro-oncol,
January 1, 2004;
6(1):
33 - 37.
[PDF]
|
|
|
|
|
|
|
S. L. Chua, M. A. Rosenthal, S. S. Wong, D. M. Ashley, A.-m. Woods, A. Dowling, and L. M. Cher
Phase 2 study of temozolomide and Caelyx in patients with recurrent glioblastoma multiforme
Neuro-oncol,
January 1, 2004;
6(1):
38 - 43.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. J. Vos, O. S. Hoekstra, F. Barkhof, J. Berkhof, J. J. Heimans, C. J. van Groeningen, W. P. Vandertop, B. J. Slotman, and T. J. Postma
Thallium-201 Single-Photon Emission Computed Tomography As an Early Predictor of Outcome in Recurrent Glioma
J. Clin. Oncol.,
October 1, 2003;
21(19):
3559 - 3565.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
The Neuro-Oncology Working Group of the German Can
Neuro-Oncology Working Group 01 Trial of Nimustine Plus Teniposide Versus Nimustine Plus Cytarabine Chemotherapy in Addition to Involved-Field Radiotherapy in the First-Line Treatment of Malignant Glioma
J. Clin. Oncol.,
September 1, 2003;
21(17):
3276 - 3284.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. F. Lang, J. M. Bruner, G. N. Fuller, K. Aldape, M. D. Prados, S. Chang, M. S. Berger, M. W. McDermott, S. M. Kunwar, L. R. Junck, et al.
Phase I Trial of Adenovirus-Mediated p53 Gene Therapy for Recurrent Glioma: Biological and Clinical Results
J. Clin. Oncol.,
July 1, 2003;
21(13):
2508 - 2518.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. A. Fine, P. Y. Wen, E. A. Maher, E. Viscosi, T. Batchelor, N. Lakhani, W. D. Figg, B. W. Purow, and C. B. Borkowf
Phase II Trial of Thalidomide and Carmustine for Patients With Recurrent High-Grade Gliomas
J. Clin. Oncol.,
June 15, 2003;
21(12):
2299 - 2304.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. A. Jaeckle, K. R. Hess, W.K. A. Yung, H. Greenberg, H. Fine, D. Schiff, I. F. Pollack, J. Kuhn, K. Fink, M. Mehta, et al.
Phase II Evaluation of Temozolomide and 13-cis-Retinoic Acid for the Treatment of Recurrent and Progressive Malignant Glioma: A North American Brain Tumor Consortium Study
J. Clin. Oncol.,
June 15, 2003;
21(12):
2305 - 2311.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M.J. Vos, B.M.J. Uitdehaag, F. Barkhof, J.J. Heimans, H.C. Baayen, W. Boogerd, J.A. Castelijns, P.H.M. Elkhuizen, and T.J. Postma
Interobserver variability in the radiological assessment of response to chemotherapy in glioma
Neurology,
March 11, 2003;
60(5):
826 - 830.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. S. Lashford, P. Thiesse, A. Jouvet, T. Jaspan, D. Couanet, P. D. Griffiths, F. Doz, J. Ironside, K. Robson, R. Hobson, et al.
Temozolomide in Malignant Gliomas of Childhood: A United Kingdom Children's Cancer Study Group and French Society for Pediatric Oncology Intergroup Study
J. Clin. Oncol.,
December 15, 2002;
20(24):
4684 - 4691.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. A. Brandes, S. Turazzi, U. Basso, L. M. Pasetto, B. Guglielmi, L. Volpin, P. Iuzzolino, P. Amista, G. Pinna, R. Scienza, et al.
A multidrug combination designed for reversing resistance to BCNU in glioblastoma multiforme
Neurology,
June 25, 2002;
58(12):
1759 - 1764.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. I. Robins, S. M. Chang, M. D. Prados, W.K. A. Yung, K. Hess, D. Schiff, H. Greenberg, K. Fink, K. Nicolas, J. G. Kuhn, et al.
A phase II trial of thymidine and carboplatin for recurrent malignant glioma: A North American Brain Tumor Consortium Study
Neuro-oncol,
April 1, 2002;
4(2):
109 - 114.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. D. Groves, V. K. Puduvalli, K. R. Hess, K. A. Jaeckle, P. Peterson, W.K. Alfred Yung, and V. A. Levin
Phase II Trial of Temozolomide Plus the Matrix Metalloproteinase Inhibitor, Marimastat, in Recurrent and Progressive Glioblastoma Multiforme
J. Clin. Oncol.,
March 1, 2002;
20(5):
1383 - 1388.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Reardon, G. Akabani, R. Edward Coleman, A. H. Friedman, H. S. Friedman, J. E. Herndon II, I. Cokgor, R. E. McLendon, C. N. Pegram, J. M. Provenzale, et al.
Phase II Trial of Murine 131I-Labeled Antitenascin Monoclonal Antibody 81C6 Administered Into Surgically Created Resection Cavities of Patients With Newly Diagnosed Malignant Gliomas
J. Clin. Oncol.,
March 1, 2002;
20(5):
1389 - 1397.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. B. Khan, J. J. Raizer, M. G. Malkin, K. A. Bazylewicz, and L. E. Abrey
A phase II study of extended low-dose temozolomide in recurrent malignant gliomas
Neuro-oncol,
January 1, 2002;
4(1):
39 - 43.
[Abstract]
[PDF]
|
|
|
|
|
|
|
A.C. Kappelle, T.J. Postma, M.J.B. Taphoorn, G.J. Groeneveld, M.J. van den Bent, C.J. van Groeningen, B.A. Zonnenberg, K.C.A. Sneeuw, and J.J. Heimans
PCV chemotherapy for recurrent glioblastoma multiforme
Neurology,
January 9, 2001;
56(1):
118 - 120.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. R. Hess, E. T. Wong, K. A. Jaeckle, A. P. Kyritsis, V. A. Levin, M. D. Prados, and W. K. A. Yung
Response and progression in recurrent malignant glioma
Neuro-oncol,
October 1, 1999;
1(4):
282 - 288.
[Abstract]
[PDF]
|
|
|
|
TOP
ABSTRACT
INTRODUCTION
