Carboplatin and etoposide for recurrent malignant glioma following surgical and radiotherapy failure: A clinical study conducted at the Northern Israel Oncology Center

Background and Objectives: We conducted a phase II study using carboplatin and etoposide on patients with recurrent malignant glioma to investigate tu mor response. Methods: From January 1995 to March 1997, 21 patients with recurrent malign ant glioma were treated with a carboplatin (300 mg/m(2), day 1)/ etoposide (100 mg/m(2), days 1-3) regimen every 3-4 weeks. The following radiologic p arameters were evaluated: tumor size, central lucency, degree of contrast e nhancement, and mass effect. No patient had received chemotherapy previousl y. Dose escalation corresponded to hematologic tolerance and to general and neurologic performance status. Most patients were treated postoperatively with involved field radiotherapy followed by a boost to the tumor area, as defined on the presurgery computed tomography scan or on magnetic resonance imaging. Mean interval to introduction of chemotherapy was 8.8 months (ran ge, 7-36 months). Patients received a mean of four cycles [range, 2-8 cycle s]. Results: Only 2 patients showed moderate radiological response, while 12 pa tients died of progressive disease. Mean time to progression following disc ontinuation of chemotherapy was 5.8 months (range, 1-11 months). The other patients survived with persistent disease and are being treated palliativel y. Toxicity was manageable (1, neutropenic sepsis; 1, thrombocytopenia (45, 000/mm(3)); 2, temporarily elevated transaminase level; 2, steroid-induced erosive gastritis). Conclusions: This phase II regimen proved to be ineffective in recurrent ma lignant glioma. Further studies incorporating innovative drug regimens and schedules are warranted. (C) 1999 Wiley-Liss, Inc.