Tolerance and feasibility of chemotherapy by procarbazine, lomustine, and vincristine (PCV) for oligodendroglial anaplastic gliomas (OAG).

Authors

null

Marine Daros

University Hospital Timone, Marseille, France

Marine Daros , Emeline Tabouret , Maryline Barrie , Mona Matta , Didier Autran , Celine Boucard , Marie Wertz , Dominique Figarella , Stéphane Honoré , Oliver L. Chinot

Organizations

University Hospital Timone, Marseille, France, University Hospital timone, Marseille, France, Université de la Méditerranée, Marseille, France

Research Funding

No funding sources reported
Background: Chemosensitivity of OAG has been documented although their role as part of adjuvant treatment combined to radiotherapy is debated. Beside temozolomide still under investigation, several studies have underlined activity of PCV regimen in this setting. However, significant toxicity has been described and dose intensity and schedule duration are not clearly reported. Methods: This monocentric retrospective analysis included all pts with OAG treated with at least 1 cycle of PVC (lomustine 110mg/m2 every 6 weeks) at our institution from August 2007 to August 2011 (pharmacy charter). Toxicities data were collected from clinical observations and blood investigations. Results: 40 pts were identified (M/F: 23/17). Median age was 45y (20 – 72). At the time of analyses, 32 pts were still alive. Histologies were oligodendroglioma (73%) or oligoastrocytoma (27%). Codeletion 1p19q was observed in 30 % of pts. PCV was administered in first or second line of chemotherapy for 60 % and 40 % of pts respectively. Seventy five percent and 52.5% of pts completed at least of 4 and 6 cycles respectively. Discontinuation of PCV occurred in 45% of pts for toxicity (10%), progression (30%), or other reason (5%). Because of toxicity 38/196 (19%) PCV cycles were delayed. Dose was adapted for 73% of pts and decreased under 60% of theoretical dose in 30% of pts at cycle 4 and in 57% of pts at cycle 6 (table1). Grade III or IV toxicity occurred in 28% of pts and only grade I-II in 50%. Neuropathies occurred in 43 % of pts. Conclusions: Despite activity of PCV regimen, significant toxicity is associated to this schedule, that impact feasibility and compliance. PVC schedule should be redefined taking into account dose intensity applied in toxicity observed.
Cycles Cumulative number (nb)
of pts under PCV
Nb of pts per dose
Total nb of
pts per cycle
% of theoretical dose of lomustine
90 – 100 % 70 – 80 % 50 – 60 % < 50 %
1 40 (100%) 23 (57.5%) 13 (32.5%) 3 (7.5%) 1 (2.5%) 6 (15%)
2 34 (85%) 18 (53%) 11 (32%) 4 (12%) 1 (3%) 2 (5%)
3 32 (80%) 12 (38%) 12 (38%) 6 (18%) 2 (6%) 2 (5%)
4 30 (75%) 10 (33%) 11 (37%) 6 (20%) 3 (10%) 3 (7.5%)
5 27 (32.5%) 8 (30%) 8 (30%) 6 (22%) 5 (18%) 6 (15%)
6 21 (52.5%) 4 (19%) 5 (24%) 7 (33%) 5 (24%) 21 (52.5%)

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Abstract Details

Meeting

2012 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Central Nervous System Tumors

Citation

J Clin Oncol 30, 2012 (suppl; abstr 2060)

DOI

10.1200/jco.2012.30.15_suppl.2060

Abstract #

2060

Poster Bd #

14G

Abstract Disclosures