OncoLog, Volume 56, Number 3, March 2011 Page: 3
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later. However, some patients require
a longer stay for rehabilitation, which
may include speech therapy or physical
therapy. "We've learned that the brain
will recover from an insult," Dr. Rao
said. "If we do our job as surgeons, these
patients will recover; it just takes some
time." Patients typically are able to begin
chemotherapy and radiation therapy
within a few weeks of surgery.
Chemotherapy and
radiation therapy
Dr. de Groot said most glioblastoma
patients will follow a standard treatment
regimen after the tumor is resected. This
consists of 6 weeks of external beam ra-
diation 5 times a week plus oral temo-
zolomide daily.
Anita Mahajan, M.D., a professor in
the Department of Radiation Oncology,
said the area around the original tumor
is treated with photons (about 60 Gy)
delivered in standard fractions using
either three-dimensional conformal ra-
diation therapy or intensity-modulated
CLINICAL TRIALS: Gli I
The following clinical trials of treatments
for glioblastoma are available at MD
Anderson.
Randomized Phase II Trial of
Standard-Dose Bevacizumab Versus
Low-Dose Bevacizumab plus
Lomustine in Adults with Recurrent
Glioblastoma Multiforme (2009-
0597). Principal investigator (PI): John
de Groot, M.D. The goal of this clinical
research study is to learn whether the
combination of bevacizumab and lomus-
tine can help to control glioblastoma.
Phase IlIl Double-Blind Placebo-
Controlled Trial of Conventional
Concurrent Chemoradiation and
AdjuvantTemozolomide plus
Bevacizumab Versus Conventional
Concurrent Chemoradiation and
AdjuvantTemozolomide in Patients
with Newly Diagnosed Glioblastoma
(RTOG0825). PI: Mark Gilbert, M.D. The
primary goal of this study is to find out
if adding bevacizumab to the combina-radiation therapy (IMRT). She said no
difference in clinical results has been
seen in the two systems, but IMRT is
preferred because of the ease in plan-
ning. "IMRT gives us more flexibility
to conform the dose to the target and
to try to spare the other side of the
brain, the brainstem, and the optic
chiasm," Dr. Mahajan said.
After the 6 weeks of combined
radiation therapy and chemotherapy,
patients continue to receive temozolo-
mide daily for 5 consecutive days in 28-
day cycles for 1 year. This regimen was
established by a 2005 study, conducted
in Europe and Canada, in which pa-
tients given adjuvant treatment with
temozolomide plus radiation therapy
had more than double the 2-year over-
all survival rate of those treated with
radiation only (27% and 10%, respec-
tively). Even with this improvement,
the 5-year overall survival rate for pa-
tients with glioblastoma remains low
around 8%.
"The treatment prolongs survival,tion of temozolomide and radiation will
help to control glioblastoma better than
treatment with temozolomide and radia-
tion alone.
A Phase I Dose-Finding Study of
the Safety and Pharmacokinetics of
XL184 Administered Orally in Com-
bination with Temozolomide and
Radiation Therapy in the First-Line
Treatment of Subjects with Malig-
nant Gliomas (2009-0476). PI: Dr. de
Groot. The main goal of this study is to
find the highest tolerable dose of XL184
that can be given in combination with
temozolomide and radiation therapy
to patients with anaplastic glioma or
glioblastoma.
Phase ITrial of Conditionally Repli-
cation-Competent Adenovirus
(Delta-24-RGD) for Recurrent Malig-
nant Gliomas (ID01-310). PI: Frederick
F Lang, M.D. The primary goal of this
study is to find the highest tolerable
dose of Delta-24-RGD that can bebut it's not destroying the microscopic
extensions of the tumor," said Dr. de
Groot. Unfortunately, most patients will
have a recurrence of glioblastoma with-
in 2 years of their original diagnosis. If a
patient has a recurrence, a limited num-
ber of treatments are available.
"A second surgery is considered for
patients with recurrent tumors when
there's a question about the diagnosis or
if it can be done very, very easily," Dr.
Mahajan said. A second course of radia-
tion therapy is sometimes given to pa-
tients whose cancer recurs in a different
area of the brain. However, Dr. Maha-
jan said, 80% or more of glioblastoma
recurrences occur in the same area as
the original tumor, precluding addition-
al radiation therapy because of toxicity
concerns.
Chemotherapeutic agents may be
used to treat recurrent glioblastoma.
For example, bevacizumab was ap-
proved in May 2009 for the treatment
of recurrent glioblastoma, and other
[Continued on page 8]injected directly into brain tumors and
into the surrounding brain tissue
where tumor cells can multiply.
Phase II Clinical Trial of ZYC300 in
Recurrent Glioblastoma Multiforme
Patients (2007-0673). PI: Amy
Heimberger, M.D. The goal of this
study is learn if the ZYC300 vaccine
given in combination with two different
dose schedules of temozolomide can
help to control the disease in patients
with glioblastoma.
A Phase II Open-Label Study of the
Efficacy of TPI 287 in Patients with
Glioblastoma Multiforme that Has
Recurred or Progressed Following
Prior Therapy with Radiation plus
Temozolomide (2009-0759). PI:
Charles Conrad, M.D. The goal of this
clinical research study is to learn if TPI
287 can help to control glioblastoma.
FOR MORE INFORMATION
Visit www clinicaltrials. org.www.mdanderson.org/oncolog 3
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University of Texas M.D. Anderson Cancer Center. OncoLog, Volume 56, Number 3, March 2011, periodical, March 2011; Houston, Texas. (https://texashistory.unt.edu/ark:/67531/metapth639235/m1/3/: accessed July 17, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.