RESPONSE OF RECURRENT GLIOBLASTOMA AND ANAPLASTIC ASTROCYTOMA TO DIBROMODULCITOL, BCNU AND PROCARBAZINE - A PHASE-II STUDY

Twenty six (17 males) patients with glioblastoma (GEL), median age 55 years, median Karnofsky Index (KI) 70/100, and 11 patients (9 males) w ith anaplastic astrocytoma (AA), median age 56 years, median KI 70/100 were treated at recurrence with dibromodulcitol (DBD) 1400 mg/m(2) on day 1, BCNU 150 mg/m(2) on day 2, and procarbazine (PCZ) 150 mg/day o n days 1 to 15. The course was repeated every 4 weeks, but was delayed or decreased by 25 % according to hematological toxicity. Response to treatment was evaluated by the criteria of MacDonald et al. (J Clin O ncol 1990; 8: 1277-1280). All GBL-patients were followed until death. One patient with complete response (CR) survived one year, and 2 patie nts with partial response (PR) survived 1 and 3 years. Ten patients wh o stabilized (SD) survived 7.5 months, and 13 patients who progressed under chemotherapy had a median survival of 3.5 months. In AA-group 3 patients were alive at the time of the analyses. Six patients: 1 CR an d 5 PR survived 6 to 40 + months. Two patients with SD survived 4 and 14 months. Three patients with progressive disease had a mean survived of less than 3 months. The response rate of 55% in AA was significant ly higher (p = 0.011) than the 12% response rate seen in GEL. We concl ude that the regimen tested appears particularly promising in AA. The results in GEL are comparable to those obtained with a single nitrosou rea, despite an increased but reversible toxicity.