Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 11 Via Celoria, 20133 Milan, Italy.
Neurol Sci. 2011 Nov;32 Suppl 2:S255-7. doi: 10.1007/s10072-011-0800-4.
Fotemustine (FTMS) is a third-generation nitrosourea, in preclinical studies, FTMS compared favorably with carmustine (BCNU) and lomustine (CCNU) against several human tumor cell lines. In conventional schedule, FTMS is administered at a dose of 100 mg/sqm/week for three consecutive weeks as induction (I) treatment, followed by 100 mg/sqm every three weeks, after a 5-week rest, as maintenance (M). Several Italian groups reported the results using FTMS in malignant glioma patients recurring after temozolomide standard treatment. In these papers, the 6-progression free survival are ranging from 20 to 52%. With the schedule (I + M) myelosuppression is observed in more than 30% of patients, and thrombocytopenia and leukopenia are more frequent and significant in Temozolomide pretreated patients. On the bases of the hematological toxicities several authors experimented new schedules of FTMS administrated at low doses. Recently, some authors reported the interesting results of a multicenter study on recurrent glioblastoma multiforme patients combining FTMS with new antiangiogentic agent bevacizumab.
福莫司汀（FTMS）是第三代亚硝脲类药物，在临床前研究中，FTMS 在多种人肿瘤细胞系中与卡莫司汀（BCNU）和洛莫司汀（CCNU）相比具有优势。在常规方案中，FTMS 以 100mg/sqm/week 的剂量连续使用 3 周作为诱导（I）治疗，然后在 5 周休息后每 3 周使用 100mg/sqm 作为维持（M）治疗。一些意大利的研究小组报告了使用 FTMS 治疗替莫唑胺标准治疗后复发的恶性胶质瘤患者的结果。在这些论文中，6 无进展生存率为 20%至 52%。在（I+M）方案中，超过 30%的患者出现骨髓抑制，并且在替莫唑胺预处理的患者中，血小板减少和白细胞减少更为频繁且更为显著。基于血液学毒性，一些作者尝试了低剂量 FTMS 的新方案。最近，一些作者报告了一项关于复发性多形性胶质母细胞瘤患者的多中心研究的有趣结果，该研究将 FTMS 与新型抗血管生成药物贝伐单抗联合使用。
