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Combination chemotherapy using carboplatin (JM-8) and etoposide (JET therapy) for recurrent malignant gliomas: a
K Watanabe1, H Kanaya, Y Fujiyama
1Division of Neurosurgery, Dokkyo University School of Medicine, Mibu, Tochighi, Japan.
Background:
To study efficacy and safety of chemotherapy using carboplatin (JM-8) and etoposide ("JET" therapy) for the treatment of recurrent malignant glioma, a phase II study was conducted. Tumour control, survival time, and toxicity/side effects were assessed in patients with recurrent malignant glioma which failed to respond to a postoperative combined auxiliary therapy comprising of IFN-beta, ACNU and radiation.
Methods:
Twenty-eight patients, fourteen with anaplastic astrocytoma (AA) and fourteen with glioblastoma (GB) were included in this study. The JET regimen consists of the intravenous administration of carboplatin (300 mg/m(2)) on day 1 and etoposide (60 mg/m(2)) on day 1 to 5, repeated every 6 weeks.
Findings:
Following the therapy, we observed partial response (PR) in five (36%) of 14 patients with AA and two (14%) of 14 with GB, and stabilization of the disease (SD) in six (43%) in each group. The mean survival/survival after recurrence was 51 months/25 months in the AA group, and 17/9 in the GB group.
Interpretations:
These results compare favorably with the natural course of recurrent malignant glioma. JET shows signs of efficacy in patients with recurrent malignant glioma, and a randomized trial comparing it to standard therapy is warranted.