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Which therapy works better in choroid plexus carcinomas?
Su G Berrak1, Diane D Liu, Brigitte Wrede
1Department of Pediatric Hematology-Oncology, Marmara University Medical Center, Altunizade, Istanbul, Turkey.
Journal of Neuro-Oncology
|October 27, 2010
Summary
Etoposide demonstrated the highest response rate in treating rare choroid plexus carcinomas (CPCs). This chemotherapy drug should be considered for future treatment protocols, though further research into novel drugs is necessary for improved survival outcomes.
Area of Science:
- Oncology
- Pediatric Oncology
- Neuro-Oncology
Background:
- Choroid plexus carcinomas (CPCs) are rare and aggressive tumors with poor prognoses.
- Current treatment strategies including surgery, radiotherapy, and chemotherapy offer survival benefits, but optimal chemotherapeutic agents remain unidentified.
- The rarity of CPCs precludes prospective clinical trials, necessitating alternative research methodologies.
Purpose of the Study:
- To evaluate the efficacy of individual chemotherapy drugs in patients with CPCs through a meta-analysis.
- To identify specific chemotherapeutic agents associated with improved response rates and survival in CPC patients.
- To provide evidence-based recommendations for future CPC treatment protocols.
Main Methods:
- A comprehensive meta-analysis was conducted using an expanded database of choroid plexus tumors identified via PubMed up to 2007 (total 906 patients).
- Analysis focused on histologically confirmed CPCs (n=361), particularly those with residual tumor post-surgery (n=130).
- Chemotherapy response and survival data were compared between patients receiving specific drugs and those who did not, employing Kaplan-Meier curves, log-rank tests, and Cox regression analysis.
Main Results:
- Etoposide exhibited the highest response rate (17/36 patients) among the evaluated chemotherapy drugs.
- Cyclophosphamide, etoposide, and carboplatin showed statistically significant survival benefits in Kaplan-Meier and log-rank analyses.
- Etoposide's survival benefit was further supported by limited Cox multiple regression analysis, while vincristine showed a marginally significant effect (P=0.07).
Conclusions:
- Etoposide is a promising agent and should be incorporated into standard treatment protocols for choroid plexus carcinomas.
- Despite improvements, overall survival rates remain unsatisfactory, highlighting the need for novel therapeutic agents.
- Prospective, multicenter studies are crucial for evaluating new drugs and further optimizing CPC treatment strategies.
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