Phase II North Central Cancer Treatment Group study of 2-chlorodeoxyadenosine in patients with recurrent glioma

There is no standard treatment for patients with recurrent gliomas, and the ir prognosis remains poor. 2-Chlorodeoxyadenosine is a purine analogue that has significant activity in many low-grade lymphoproliferative disorders. The authors conducted a phase II study to determine the efficacy of 2-chlor adeoxyadenosine in patients with recurrent gliomas. Patients with a histolo gically confirmed primary brain tumor with evidence of progression after ra diation therapy were eligible, Protocol treatment consisted of 2-chlorodeox yadenosine 7.0 mg/m(2) intravenously on days 1 through 5 every 28 days. For those with a history of prior nitrosourea therapy, the dose of 2-chlorodeo xyadenosine was reduced to 5.6 mg/m(2) on days I through 5. Treatment was c ontinued until progression or a maximum of 12 cycles. Fifteen patients with recurrent astrocytomas or oligoastrocytomas of all grades were entered in the study. Treatment was well tolerated. Major toxicities were myelosuppres sion and neurotoxicity. No responses were seen. The authors conclude that a lthough 2-chlorodeoxyadenosine is well tolerated, no demonstrable activity in patients with recurrent gliomas was established.