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Published on: October 27, 2014
Teniposide (VM-26) in brain tumors
1Scientific Department, Cancer Research Campaign, London, England.
Abstract:
Although teniposide activity in glioma was reported as early as 1971, it is only within the last 2 to 3 years that its effectiveness in small cell lung cancer and, most dramatically, in associated brain metastasis, has undergone long overdue systematic investigation. The drug appears to enjoy preferential uptake by brain-tumor tissue compared with disease-free brain tissue. Single-agent activity of teniposide in astrocytomas has been widely reported but the data are difficult to interpret due to differences among studies in definition of response and response duration. Combination therapy has focused primarily on teniposide with nitrosoureas and, again, definition variations have made it difficult to evaluate data. Similar problems plague trials by one group of investigators who reported that the combination of teniposide with doxorubicin and lomustine resulted in regression or improvement in significant percentages of their patients. While many studies indicate that teniposide has significant potential in treatment of adult glioma, controlled trials are needed to evaluate and optimize the use of this agent.
Insights
Teniposide shows promise for treating brain tumors, particularly small cell lung cancer with brain metastasis, due to preferential uptake in tumor tissue. Further controlled trials are needed to optimize its use in adult glioma treatment.
Area of Science:
- Neuro-oncology
- Medical oncology
- Pharmacology
Background:
- Teniposide's activity in glioma was noted in 1971.
- Recent investigations focus on its efficacy in small cell lung cancer and brain metastases.
- Preferential uptake of teniposide in brain tumor tissue has been observed.
Purpose of the Study:
- To systematically investigate the effectiveness of teniposide in small cell lung cancer and associated brain metastases.
- To evaluate the single-agent activity and combination therapy of teniposide in adult glioma.
- To highlight the need for controlled trials to optimize teniposide's clinical application.
Main Methods:
- Review of existing literature on teniposide's use in glioma and brain metastases.
- Analysis of studies reporting single-agent activity in astrocytomas.
- Examination of combination therapy trials, particularly with nitrosoureas, doxorubicin, and lomustine.
Main Results:
- Teniposide demonstrates effectiveness in small cell lung cancer and brain metastases.
- Single-agent activity in astrocytomas is reported, but data interpretation is challenging due to study variations.
- Combination therapy results are difficult to evaluate consistently due to differing response definitions.
Conclusions:
- Teniposide shows significant potential for treating adult glioma.
- Variations in study designs and response definitions hinder definitive evaluation of teniposide's efficacy.
- Controlled clinical trials are essential to confirm and optimize teniposide's role in glioma treatment.
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