Conventional Treatment
The purpose of this site is to encourage brain tumor patients to improve
their survival odds through research and evidence-based strategies. If you do
nothing more than standard treatment, you
are condemned to the dismal statistics of that protocol. When famous Harvard
zoologist Stephen Jay Gould received his own "terminal" cancer diagnosis, he
noted in an essay called The Median Isn't the
Message that survival should not be dictated by grim statistics. After
finding and completing a promising clinical trial, he beat
his cancer and lived another productive 20 years.
Using evidence-based strategies to improve upon standard therapy, there are
numerous indications that overall survival improves. Simply because your doctor
does not offer you more than standard treatment does not mean that better
treatments do not exist.
The best survival odds for glioblastoma patients currently include
immunotherapies (vaccines), the Novo-TTF device, and several drug cocktails.
Newly diagnosed patients should first review the Upon Diagnosis section of this site. Many
factors may help improve individual odds of surviving glioblastoma and these
factors are discussed in Improving Standard
Treatment.
The following tables summarize the results of many different conventional
treatments. Some treatments are only available as part of a clinical study, while others
may not be covered yet by insurance without appeals from your doctor.
Please double-check accuracy of any numbers yourself before relying on them.
Blank boxes do not necessarily mean the data was not reported. It may simply mean we haven't
had time to evaluate the data yet.
Additional data points will be added as each study is further evaluated.
Each row in the tables below is a different clinical study.
Treatments for Newly Diagnosed Glioblastoma
Click the column headers to sort the table by that column. Not compatible with some older browsers.
| Standard Treatment (ST) |
6.9 |
53.90% |
573 |
56 |
14.6 |
3,4 |
7.00% |
26.50% |
Stupp, 2005 |
3% of patients had Grade III tumor |
Link |
| Gliadel3 |
|
|
250 |
55 |
13.5 |
|
|
20.00% |
Attenello, 2008 |
A Johns Hopkins study |
Link |
| Gliadel + ST |
6.4 |
|
35 |
57 |
18.6 |
|
|
|
LaRocca, 2006 |
1 patient was Grade III, not GBM |
Link |
| Gliadel + RT + Rotational Chemo |
|
|
85 |
55 |
22.4 |
|
|
|
Rich, 2007 |
The Rotational Chemo included CCNU, TMZ, and CPT-11 |
Link |
| Lomustine + ST |
9 |
61.30% |
31 |
51 |
22.6 |
2,3,4 |
19.00% |
44.70% |
Herrlinger, 2006 |
Hard on the blood; MGMT promoter methylation predicted survival |
Link |
| Avastin + ST |
10 |
|
10 |
54.3 |
|
3,4 |
30.00% |
|
Lai, 2007 |
Very small UCLA study: Median PFS has not been reached yet as of this study; DVTs occurred in 30% of patients |
Link |
| Tarceva + ST |
|
|
97 |
|
15.3 |
|
|
|
Brown, 2008 |
No subgroup of patients sensitive to erlotinib. Long-term survival may yet be realized in a subgroup. |
Link |
| Chloroquine + BCNU |
|
|
30 |
40.8 |
24 |
04 |
|
|
Sotelo, 2006 |
Ave. age was young, but results of this double-blind, placebo-controlled test are impressive |
Link |
| NovoCure + ST |
38.75 |
|
10 |
|
402 |
|
|
|
Press Release, 2008 |
By far the most impressive results of any GBM treatment in clinical study |
Link |
1 The number of patients in this study, or this arm of the study
2 This end point has not been reached yet, so this number will surely go higher
3 It is unclear whether the protocols in this large retrospective study also allowed chemo, and if so, what types
4 No toxicities attributed to the chloroquine; BCNU has well-documented toxicities
5 WHO Grade toxicity numbers greater than 1 are noted
6 The percent of patients in the study with reported Grades 3, 4 and 5 toxicities
Treatments for Recurrent Glioblastoma
| TMZ + CPT-11 |
|
35.00% |
33 |
n/a |
n/a |
3 |
12.00% |
n/a |
Loghin, 2007 |
Phase I trial only |
Link |
| TMZ + Doxorubicin |
|
23.00% |
31 |
|
7 |
3,4 |
18.00% |
|
Glas, 2007 |
Used Caelyx formulation |
Link |
| Tamoxifen + Carboplatin |
|
|
17 |
|
|
3,4 |
19.00% |
|
Tang, 2006 |
Long-term survival achieved by a small subset; authors felt the results were similar to Tamoxifen alone |
Link |
| Avastin + Stereotactic Radiation |
7 |
|
|
|
10 |
|
|
|
Gutin |
|
|
| Dendritic Cell Immunotherapy |
3 |
|
56 |
|
9.6 |
0 |
0.00% |
14.08% |
De Vleeschouwer, 2008 |
No other chemo or therapy was given |
Link |
| Cintredekin Besudotox (IL-13 PE38QQR) |
|
|
45 |
|
13.9 |
|
|
18.50% |
NeoPharm, 2007 |
A conjugated molecule delivered via CED. Results taken from the optimally placed arm of Phase I/II trials at UCSF. Look for Phase III PRECISE trial in 2009 (in India only) |
Link |
| AP 12009 |
|
|
28 |
|
|
|
|
|
Bogdahn, 2008 |
A TGF-beta2 inhibitor. Trial results are non-standard, but better than TMZ controls using a monotherapy of AP 12009. Look for Phase III trial in 2008 |
Link |
| Avastin + CPT-11 |
6 |
46% |
35 |
49 |
10.5 |
2,3,4 |
31.4% |
|
Vredenburgh, 2007 |
57% showed a response, and 6 had no sign of any malignancy after 1 year. Many recruited patients had very poor prognoses in general. 2 patients died of treatment-related issues (stroke and pulmonary embolus) |
Link |
| TMZ TEGWONDO Schedule |
|
39% |
18 |
54.8 |
9.1 |
3,4 |
33% |
|
Strik, 2008 |
This study included moderate dose-dense schedules of TMZ (50-130 mg/m2) on a 21/28 or 5/7 schedule, depending on dose-limiting toxicities. TEGWONDO stands for temozolomide-glioma-working day-dose-dense schedule. |
Link |
| TMZ |
3.1 |
21% |
225 |
|
|
|
|
|
Yung, 2000 |
6-month overall survival was 60%. Only half of the stated patient count participated in this arm |
Link |
| BCNU |
3.3 |
17.5% |
40 |
49.7 |
7.53 |
|
|
|
Brandes, 2004 |
BCNU toxicity is high and recovery is slow, although survival is comparable to TMZ |
Link |
| Hydroxyurea + Gleevec |
2.5 |
32% |
30 |
44 |
4.75 |
2 |
0% |
|
Dresemann, 2003 |
Very low toxicities. A better PFS6 than 2 large TMZ studies. 2-year progression-free survival rate was 16%. Patients experiencing response or stable disease yielded a combined clinical benefit rate of 57% |
Link |
| Hydroxyurea + Gleevec |
|
27% |
33 |
|
3.6 |
3 |
|
|
Reardon, 2005 |
|
Link |
|
