Health
New hypofractionated proton therapy for elderly patients with newly diagnosed glioblastoma
Written by Matthew Stenger
Posted on: 2024/11/27 9:00:00 AM
Last updated:
In a phase II study reported in lancet oncologyVora et al. discovered a short course of hypofractionated proton therapy induced by 3,4-dihydroxy-6-.[F-18]Fluoro-L-phenylalanine (F-18-DOPA) positron emission tomography (PET) and contrast-enhanced MRI yielded favorable outcomes in patients aged 65 years and older with newly diagnosed glioblastoma.
Research details
In this study, 39 patients (median age = 70.2 years) enrolled at the Phoenix and Rochester Mayo Clinics between May 2019 and May 2021 were included in the study, including 5 patients (median age = 70.2 years) with tumor volume ≤ 65 cm.3) or 10 treatments (tumor volume > 65 cm3) plus 75 mg/m of temozolomide2 daily from days 1 to 7 for the 5-treatment regimen and from days 1 to 14 for the 10-treatment regimen. One month after completion of radiation therapy, patients received adjuvant temozolomide at 150 to 200 mg/m.2 Six 28-day cycles, days 1 to 5. The primary endpoint was overall survival at 12 months.
Main findings
Median follow-up at data cutoff (January 2024) was 25.4 months (interquartile range = 22.1-29.7 months). 22 of 39 patients (56%, 95% confidence interval) [CI] = 39%–72%) were alive at 12 months. Median overall survival was 13.1 months (95% CI = 11.1 to 19.1 months). As the researchers noted, this result compared favorably with the median overall survival of 6 to 9 months and 12-month survival rate of 33% observed in historical control groups.
Median progression-free survival at data cutoff was 7.1 months (95% CI = 6.0 to 11.0 months). Progression-free survival at 12 months was 31% (95% CI = 19% to 49%).
All patients completed the course of radiotherapy with temozolomide without treatment interruption. Grade 3 treatment-related adverse events occurred in 5 patients (13%), including CNS necrosis in 4 (10%) and thrombocytopenia in 1 (3%). No treatment-related grade 4 or 5 adverse events were observed.
The researchers concluded: [F-18–DOPA] PET-guided dose escalation hypofractionated proton therapy. These findings led to a Phase 2 trial (NCT05781321) comparing this therapy to standard care in adults of all ages with newly diagnosed glioblastoma. ”
Dr. Sujay A. Vorais the corresponding author at the Mayo Clinic in Phoenix. lancet oncology article.
Disclosure: This study was funded by the Mayo Clinic's Marley Endowment and the Lawrence W. and Marilyn W. Mattson Foundation for Cancer Research. For full research author disclosure, please visit: www.thelancet.com.
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