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Published on: October 27, 2014
A case of relapsing glioblastoma multiforme responding to vinorelbine
V Biassoni1, M Casanova, F Spreafico
1Department of Pediatric, Istituto Nazionale per lo Studio e la Cura dei Tumori, 20133, Milan, Italy. acinorev26@virgilio.it
Abstract:
Childhood malignant gliomas are rare and their clinical behavior is almost as aggressive as in adults: they resist treatment, progress rapidly and often spread. Therapeutic strategies at relapse deserve an experimental approach, since none of the conventional-dose treatments have demonstrated a clear superiority over the others and no randomized trials have proved that high-dose chemotherapy is better than conventional treatment. Vinorelbine is a semi-synthetic vinca alkaloid with an in vitro and in vivo experimentally proven broad spectrum of activity, including against malignant brain glioma. We report our experience with a 19-year-old girl with glioblastoma multiforme (GBM) of the deep temporal region recurring 6 months after completing an intensive treatment that included preradiation chemotherapy (chemotherapy as a preradiation "sandwich" phase) with a myeloablative course of thiotepa, tumor bed radiotherapy and postradiation maintenance chemotherapy. The GBM proved fully responsive to intravenous vinorelbine, with a subsequent progression-free interval lasting more than 24 months. This case report suggests that vinorelbine is effective against high-grade pediatric glioma and, since this evidence has only one precedent in the literature (and given the generally poor prognosis for this tumor), even this single success seems worth reporting.
Insights
This case report highlights the effectiveness of vinorelbine in treating recurrent pediatric glioblastoma multiforme (GBM). Intravenous vinorelbine achieved a significant progression-free interval, suggesting its potential as a therapeutic option for aggressive childhood brain tumors.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Pharmacology
Background:
- Childhood malignant gliomas, including glioblastoma multiforme (GBM), exhibit aggressive behavior and poor treatment response.
- Established therapeutic strategies for recurrent pediatric gliomas lack clear superiority, necessitating experimental approaches.
- Vinorelbine, a vinca alkaloid, demonstrates broad-spectrum anticancer activity, including against malignant brain gliomas in preclinical studies.
Observation:
- A 19-year-old female patient with recurrent glioblastoma multiforme (GBM) was treated with intravenous vinorelbine.
- The patient had previously undergone intensive multimodal therapy, including chemotherapy, radiotherapy, and myeloablative treatment.
- The GBM showed a complete response to vinorelbine treatment.
Findings:
- Intravenous vinorelbine induced a durable response in a patient with recurrent pediatric glioblastoma multiforme.
- The patient achieved a progression-free interval exceeding 24 months following vinorelbine administration.
- This case represents a significant positive outcome in a typically aggressive and difficult-to-treat pediatric brain tumor.
Implications:
- Vinorelbine shows promise as an effective treatment for high-grade pediatric gliomas, particularly in recurrent settings.
- Further investigation into vinorelbine-based regimens for pediatric malignant gliomas is warranted due to the limited treatment options and poor prognosis.
- This report contributes valuable evidence supporting the exploration of novel therapeutic agents in pediatric neuro-oncology.
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