Division of Medical Oncology & Hematopoietic Cell Transplant Unit, Department of Medicine, Metaxa Cancer Hospital, Piraeus, Greece.
Anticancer Drugs. 2021 Mar 1;32(3):330-336. doi: 10.1097/CAD.0000000000001021.
Glioblastoma multiforme is a malignant central nervous system (CNS) disease with dismal prognosis. Current treatment modalities only offer modest activity and usually of short duration, so there is an urgent need for the conduct of clinical trials exploring new treatment options and modalities. The vincristine-irinotecan-temozolomide and bevacizumab (VITb) regimen is an option of special interest, as it has produced encouraging results in young patients with various relapsed/refractory childhood and adolescence solid tumors, with an acceptable toxicity profile. With the current report, we present the case of a young male patient who was treated for GBM in second relapse at out institution, after previous surgical attempts and two radiotherapy sessions in conjunction with temozolomide and experienced a major and long-lasting response, weaned off steroids, to the VITb regimen followed by bevacizumab maintenance. The above case is discussed in the context of the existing literature regarding available evidence of synergy between the drugs used and the activity of certain components of the combination (i.e. combination of temozolomide-irinotecan ± vincristine, or bevacizumab-irinotecan in GBM) or the complete VITb regimen in other pediatric/adolescence solid tumors and the few cases reported with GBM.
胶质母细胞瘤是一种恶性的中枢神经系统 (CNS) 疾病,预后不良。目前的治疗方法仅提供适度的疗效,且通常持续时间较短,因此迫切需要开展临床试验,探索新的治疗选择和方法。长春新碱-伊立替康-替莫唑胺联合贝伐珠单抗 (VITb) 方案是一个特别引人关注的选择,因为它在各种复发/难治性儿童和青少年实体瘤年轻患者中产生了令人鼓舞的结果,具有可接受的毒性特征。通过本报告,我们介绍了一名年轻男性患者的病例,他在我们机构的第二次复发中接受了胶质母细胞瘤的治疗,此前曾进行过两次手术尝试和两次与替莫唑胺联合的放疗,并且对 VITb 方案产生了重大且持久的反应,停用了类固醇,然后接受了贝伐珠单抗维持治疗。上述病例在现有文献的背景下进行了讨论,涉及到现有证据表明联合用药之间存在协同作用,以及联合用药的某些成分(即替莫唑胺-伊立替康联合±长春新碱,或贝伐珠单抗-伊立替康联合治疗胶质母细胞瘤)或其他儿科/青少年实体瘤中完整的 VITb 方案的活性,以及少数胶质母细胞瘤的报告病例。