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Published on: October 27, 2014
[Nimotuzumab in combination with chemotherapy for patients with malignant gliomas]
Qun-ying Yang1, Dong Shen, Ke Sai
1State Key Laboratory of Oncology in South China.
Objective:
Nimotuzumab is a humanized monoclonal antibody targeted against epidermal growth factor receptor (EGFR). Recent clinical studies show that patients with malignant gliomas could benefit from nimotuzumab treatment. The aim of the present study was to evaluate the efficacy and side effects of nimotuzumab in combination with chemotherapy for patients with malignant gliomas.
Methods:
The patients received 200 mg of nimotuzumab infusion intravenously over 60 minutes once weekly for the first eight weeks and then once every two weeks until unacceptable toxicity or tumor progression occurred. Individualized chemotherapy was administered based on O(6)-methylguanine-DNA methyltransferase (MGMT) expression and previous chemotherapy responses in combined with nimotuzumab.
Results:
Fourteen patients received a total of 122 times of nimotuzumab ranging from 2 to 20 (median 7.5 times). Combined chemotherapy regimens included: continuous 21-day temozolomide (10 cases), standard 5-day temozolomide (2 cases), teniposide plus cisplatin (1 case), and teniposide plus nimustine (1 case). Partial response (PR) and stable disease (SD) were found in 3 patients (21.4%)and 6 patients (42.9%), respectively. Disease control rate (PR + SD) was 64.3%. The median progression-free survival (PFS) was 4 months (95%CI: 0.7 - 7.3) and PFS at 6 months was 30.6%. The most common toxicities include grade I-II neutropenia (2 cases), thrombocytopenia (2 cases), lymphopenia (1 case), nausea and vomitting (3 case) and asymptomatic transaminase increase (1 case). One patient developed grade IV neutropenia and thrombocytopenia. One patient developed nimotuzumab-related acneiform rash.
Conclusions:
Nimotuzumab in combination with chemotherapy has moderate activity in patients with malignant gliomas and the toxicities are well tolerable, therefore, worth further investigation.
Insights
Nimotuzumab combined with chemotherapy shows moderate efficacy in treating malignant gliomas, with a 64.3% disease control rate. The treatment was generally well-tolerated, indicating potential for further clinical investigation.
Area of Science:
- Oncology
- Immunotherapy
- Neuro-oncology
Background:
- Nimotuzumab is a monoclonal antibody targeting the epidermal growth factor receptor (EGFR).
- Malignant gliomas are aggressive brain tumors with limited treatment options.
- Prior studies suggest potential benefits of nimotuzumab in glioma patients.
Purpose of the Study:
- To evaluate the efficacy of nimotuzumab in combination with chemotherapy for malignant gliomas.
- To assess the safety and tolerability profile of this combined treatment regimen.
Main Methods:
- Fourteen patients with malignant gliomas received nimotuzumab (200 mg weekly, then bi-weekly).
- Chemotherapy was individualized based on MGMT expression and prior response.
- Treatment continued until toxicity or progression.
Main Results:
- A disease control rate (partial response + stable disease) of 64.3% was observed.
- Median progression-free survival (PFS) was 4 months, with 30.6% PFS at 6 months.
- Common toxicities included grade I-II neutropenia, thrombocytopenia, and nausea; one patient had grade IV neutropenia/thrombocytopenia and another developed rash.
Conclusions:
- Nimotuzumab plus chemotherapy demonstrates moderate activity in malignant gliomas.
- The combination therapy is generally well-tolerated, with manageable side effects.
- Further investigation of this treatment approach is warranted.
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