New P, Vokes E, Rogers L, Bazan C, Hohneker J, Eble M, Vilk P
University of Texas Health Science Center, San Antonio, USA.
Invest New Drugs. 1997;15(4):343-52. doi: 10.1023/a:1005968700694.
A total of 26 patients (6 with anaplastic astrocytoma; 20 with glioblastoma) were treated with crisnatol mesylate. All patients had residual or progressive disease following surgery and standard radiotherapy; nine patients had prior chemotherapy. Crisnatol was administered as a 72-hour infusion every 21 days at a starting dose of 2250 mg/m2. Two patients who had not received prior chemotherapy achieved a complete response and remain in continuous complete remission over seven and six years, respectively, post-diagnosis. Two other patients remained stable on crisnatol for 10 months before disease progression. One patient with mixed oligodendroglioma/glioblastoma progressed after 12 months on crisnatol. He survives at 7 years post-diagnosis, with Karnofsky Performance Status of 60 following other therapies. One patient with anaplastic astrocytoma stopped treatment by request after 10 months and remains stable 64 months post diagnosis. Seventeen evaluable patients, including nine patients with prior chemotherapy, progressed after 2-9 courses of therapy. Median survival is 9.25 months, with a one year survival rate of 30% and 2 years survival rate of 17%. Neurotoxicity was acute and dose-limiting. Side effects were tolerable and limited to duration of infusion. Two complete, long-lasting responses to crisnatol mesylate in patients with progressive malignant glioma are encouraging results and warrant further investigation.
共有26例患者（6例间变性星形细胞瘤；20例胶质母细胞瘤）接受了甲磺酸克立那托治疗。所有患者在手术及标准放疗后均有残留或进展性疾病；9例患者曾接受过化疗。克立那托以2250 mg/m²的起始剂量每21天进行一次72小时静脉输注。2例未接受过化疗的患者获得了完全缓解，分别在诊断后七年和六年仍处于持续完全缓解状态。另外2例患者在疾病进展前，使用克立那托病情稳定了10个月。1例混合性少突胶质细胞瘤/胶质母细胞瘤患者在使用克立那托12个月后病情进展。他在诊断后7年存活，在接受其他治疗后卡氏功能状态评分为60。1例间变性星形细胞瘤患者在10个月后应要求停止治疗，诊断后64个月仍保持稳定。17例可评估患者，包括9例曾接受化疗的患者，在2 - 9个疗程的治疗后病情进展。中位生存期为9.25个月，一年生存率为30%，两年生存率为17%。神经毒性是急性且剂量限制性的。副作用可耐受，且仅限于输注期间。甲磺酸克立那托对进展性恶性胶质瘤患者产生的2例完全、持久反应是令人鼓舞的结果，值得进一步研究。
