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Phase I study of intracarotid PCNU
D J Stewart1, Z Grahovac, N A Russel
1Ontario Cancer Treatment and Research Foundation, Ottawa Regional Cancer Centre, Canada.
Journal of Neuro-Oncology
|January 1, 1987
Summary
Intracarotid PCNU showed a 41% response rate in recurrent brain tumors. While effective, it caused dose-limiting thrombocytopenia and CNS toxicity, with visual impairment also noted.
Area of Science:
- Neuro-oncology
- Clinical Pharmacology
Background:
- Recurrent intracerebral tumors after radiation pose significant treatment challenges.
- Intracarotid chemotherapy offers a targeted approach to deliver agents directly to the brain.
Purpose of the Study:
- To evaluate the safety and efficacy of intracarotid PCNU in patients with recurrent brain tumors.
- To determine the dose-limiting toxicities and response rates of this treatment modality.
Main Methods:
- Phase I clinical trial involving intracarotid administration of PCNU.
- Seventeen patients with recurrent gliomas or brain metastases were treated.
- Response was assessed, and toxicities were meticulously recorded.
Main Results:
- A 41% overall response rate was observed (44% in glioma patients).
- Thrombocytopenia and reversible CNS toxicity were dose-limiting at 110 mg/m2.
- Permanent visual impairment occurred in 3 patients; transient CNS toxicity was more common than with BCNU.
Conclusions:
- Intracarotid PCNU demonstrates activity in recurrent brain tumors.
- Dose-limiting toxicities include thrombocytopenia and CNS effects.
- PCNU may offer an alternative to BCNU with potentially less ocular pain but more transient CNS toxicity.