Adjuvant Procarbazine, Lomustine, and Vincristine Chemotherapy in Newly Diagnosed Anaplastic Oligodendroglioma: Long-Term Follow-Up of EORTC Brain Tumor Group Study 26951

Author:

van den Bent Martin J.1,Brandes Alba A.1,Taphoorn Martin J.B.1,Kros Johan M.1,Kouwenhoven Mathilde C.M.1,Delattre Jean-Yves1,Bernsen Hans J.J.A.1,Frenay Marc1,Tijssen Cees C.1,Grisold Wolfgang1,Sipos László1,Enting Roelien H.1,French Pim J.1,Dinjens Winand N.M.1,Vecht Charles J.1,Allgeier Anouk1,Lacombe Denis1,Gorlia Thierry1,Hoang-Xuan Khê1

Affiliation:

1. Martin J. van den Bent, Johan M. Kros, Mathilde C.M. Kouwenhoven, Roelien H. Enting, Pim J. French, and Winand N.M. Dinjens, Erasmus MC–Daniel den Hoed Cancer Center, Rotterdam; Martin J.B. Taphoorn and Charles J. Vecht, Medical Center Haaglanden, The Hague; Martin J.B. Taphoorn, Vrije Universiteit Medisch Centrum, Amsterdam; Hans J.J.A. Bernsen, Canisius Wilhelmina Ziekenhuis, Nijmegen; Cees C. Tijssen, St Elisabeth Hospital, Tilburg; Roelien H. Enting, University Medical Center Groningen, Groningen,...

Abstract

Purpose Anaplastic oligodendroglioma are chemotherapy-sensitive tumors. We now present the long-term follow-up findings of a randomized phase III study on the addition of six cycles of procarbazine, lomustine, and vincristine (PCV) chemotherapy to radiotherapy (RT). Patients and Methods Adult patients with newly diagnosed anaplastic oligodendroglial tumors were randomly assigned to either 59.4 Gy of RT or the same RT followed by six cycles of adjuvant PCV. An exploratory analysis of the correlation between 1p/19q status and survival was part of the study. Retrospectively, the methylation status of the methyl-guanine methyl transferase gene promoter and the mutational status of the isocitrate dehydrogenase (IDH) gene were determined. The primary end points were overall survival (OS) and progression-free survival based on intent-to-treat analysis. Results A total of 368 patients were enrolled. With a median follow-up of 140 months, OS in the RT/PCV arm was significantly longer (42.3 v 30.6 months in the RT arm, hazard ratio [HR], 0.75; 95% CI, 0.60 to 0.95). In the 80 patients with a 1p/19q codeletion, OS was increased, with a trend toward more benefit from adjuvant PCV (OS not reached in the RT/PCV group v 112 months in the RT group; HR, 0.56; 95% CI, 0.31 to 1.03). IDH mutational status was also of prognostic significance. Conclusion The addition of six cycles of PCV after 59.4 Gy of RT increases both OS and PFS in anaplastic oligodendroglial tumors. 1p/19q-codeleted tumors derive more benefit from adjuvant PCV compared with non–1p/19q-deleted tumors.

Publisher

American Society of Clinical Oncology (ASCO)

Subject

Cancer Research,Oncology

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