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Glioblastoma Treatments: Conventional Treatments Languages Supported

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

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Protocol Median PFS (mo) PFS-6 N1 Median Age Median OS (mo) Toxicities5 Toxicity Incidence6 2-Yr Survival Study Notes Link
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 To date, the #1 best results of any GBM treatment in clinical study Link
ICT-107 (Cedars Sinai) Monotherapy 19.0
16 47 >202 0 0.00% 18.75% Press Relese, 2009 A Phase I autologous immunotherapy trial. There were no side-effects. Patients must be HLA-A1 and/or HLA-A2-positive. Link
DCVax-Brain + ST 26.4
20
36.4 0 0.00% 68% Press Release, 2009 Combined Phase I/II autologous immunotherapy trial. A large multi-center Phase II is under way. To date, the #2 best results of any GBM treatment in clinical study Link
CDX-110 Monotherapy 14.2
18
26 0 0.00%
Press Release, 2009 Phase II ACTIVATE autologous immunotherapy trial. Requires EGFRvIII mutation. Link
CDX-110 + ST 15.2
22
>23.62 0 0.00%
Press Release, 2009 Phase II ACT II autologous immunotherapy trial. Requires EGFRvIII mutation. Matched control patients had median PFS: 6.3 months; median OS: 15.0 months 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

Protocol Median PFS (mo) PFS-6 N1 Median Age Median OS (mo) Toxicities Toxicity Incidence 2-Yr Survival Study Notes Link
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
Oncophage (vitespen) Immunotherapy

20
10.1 0 0.00%
Parsa, 2009 (ASCO) Very early Phase II data; study apparently includes Stage 3 and 4 glioma patients in unknown stratification 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




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