Localized BCNU chemotherapy and the multimodal management of malignant glioma

Current Medical Research and Opinion

Volumn 25, Issue 1, 2009, Pages 149-160

  La Rocca, Renato V ^a   Maximilian Mehdorn, H ^b  

^a Kentuckiana Cancer Institute   (United States)

^b UNIVERSITY OF KIEL   (Germany)

Author keywords

BCNU wafer; Carmustine wafer; Glioblastoma; Glioma; Multimodal treatment; Temozolomide

Indexed keywords

6 O BENZYLGUANINE; BEVACIZUMAB; CARBOPLATIN; CARMUSTINE; CDX 110; CEDIRANIB; CETUXIMAB; CILENGITIDE; CINTREDEKIN BESUDOTOX; CISPLATIN; ENZASTAURIN; ERLOTINIB; ETOPOSIDE; EVEROLIMUS; INTERFERON; IRINOTECAN; LENALIDOMIDE; LOMUSTINE; LONAFARNIB; MARIMASTAT; POLYDEOXYRIBONUCLEOTIDE SYNTHASE; PROCARBAZINE; TEMOZOLOMIDE; TEMSIROLIMUS; THALIDOMIDE; TOPOTECAN; UNCLASSIFIED DRUG; UNINDEXED DRUG; VALPROIC ACID; VATALANIB; VINCRISTINE; VORINOSTAT; ALKYLATING AGENT;

ATAXIA; BACTERIAL PNEUMONIA; BIOSIS; BLOOD TOXICITY; BRACHYTHERAPY; BRAIN ABSCESS; CANCER ADJUVANT THERAPY; CANCER COMBINATION CHEMOTHERAPY; CANCER RADIOTHERAPY; CANCER SURGERY; CANCER SURVIVAL; CONTINUOUS INFUSION; CYTOREDUCTIVE SURGERY; DEEP VEIN THROMBOSIS; DRUG DOSE ESCALATION; DRUG EFFICACY; DRUG SAFETY; DRUG WITHDRAWAL; EMBASE; ENCEPHALITIS; EXTERNAL BEAM RADIOTHERAPY; FOLLOW UP; GLIOBLASTOMA; HEADACHE; HUMAN; INFORMATION RETRIEVAL; LUNG EMBOLISM; MEDLINE; MULTIMODALITY CANCER THERAPY; NEUTROPENIA; NUCLEAR MAGNETIC RESONANCE IMAGING; PROSPECTIVE STUDY; RETROSPECTIVE STUDY; REVIEW; SEIZURE; SIDE EFFECT; THROMBOCYTOPENIA; WOUND INFECTION; BRAIN TUMOR; GLIOMA; PROGNOSIS;

ANTINEOPLASTIC AGENTS, ALKYLATING; BRAIN NEOPLASMS; CARMUSTINE; GLIOMA; HUMANS; PROGNOSIS;

EID: 64249172854     PISSN: 03007995     EISSN: 14734877     Source Type: Journal    
DOI: 10.1185/03007990802611935     Document Type: Review

References (103)

1. Sant M, Aareleid T, Berrino F, et al. EUROCARE-3: survival of cancer patients diagnosed 1990-1994-results and commentary. Ann Oncol 2003;14(Suppl 5):v61-118
2. Stupp R. Malignant glioma: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 2007;18(Suppl 2):ii69-70
3. Boyle P, Ferlay J. Cancer incidence and mortality in Europe, 2004. Ann Oncol 2005;16:481-488
4. Ashby LS, Ryken TC. Management of malignant glioma: steady progress with multimodal approaches. Neurosurg Focus 2006;20:E3
5. Stupp R, Hegi ME, Gilbert MR, et al. Chemoradiotherapy in malignant glioma: standard of care and future directions. J Clin Oncol 2007;25:4127-4136
6. Soffietti R, Leoncini B, Ruda R. New developments in the treatment of malignant gliomas. Expert Rev Neurother 2007;7:1313-1326
7. Laws ER, Parney IF, Huang W, et al. Survival following surgery and prognostic factors for recently diagnosed malignant glioma: data from the Glioma Outcomes Project. J Neurosurg 2003;99:467-473
8. Anderson E, Grant R, Lewis SC, et al. Randomized phase III controlled trials of therapy in malignant glioma: where are we after 40 years? Br J Neurosurg 2008;22:339-349
9. Kelly KA, Kirkwood JM, Kapp DS. Glioblastoma multiforme: pathology, natural history and treatment. Cancer Treat Rev 1984;11:1-26
10. Laperriere N, Zuraw L, Cairncross G. Radiotherapy for newly diagnosed malignant glioma in adults: a systematic review. Radiother Oncol 2002;64:259-273
11. Bocangel DB, Finkelstein S, Schold SC, et al. Multifaceted resistance of gliomas to temozolomide. Clin Cancer Res 2002;8:2725-2734
12. Brandes AA, Tosoni A, Amista P, et al. How effective is BCNU in recurrent glioblastoma in the modern era? A phase II trial. Neurology 2004;63:1281-1284
13. Medical Research Council Brain Tumour Working Party: Randomized trial of procarbazine, lomustine, and vincristine in the adjuvant treatment of high-grade astrocytoma: a Medical Research Council trial. J Clin Oncol 2001;19:509-518
14. Stummer W, Reulen HJ, Meinel T, et al. Extent of resection and survival in glioblastoma multiforme: identification of and adjustment for bias. Neurosurgery 2008;62:564-576
15. Sampath P, Brem H. Implantable slow-release chemotherapeutic polymers for the treatment of malignant brain tumors. Cancer Control 1998;5:130-137
16. Gliadel® Wafer [prescribing information]. MGI PHARMA, Bloomington, MN, USA. 2006
17. Gliadel® Wafer [summary of product characteristics]. Link Pharmaceuticals Ltd, West Sussex, UK. 2006
18. Temodar® [prescribing information]. Schering-Plough Pharmaceuticals, Kenilworth, NJ, USA. 2006
19. Temodal® [summary of product characteristics]. SP Europe, Bruxelles, Belgium. 2007
20. Sulman E, Aldape K, Colman H. Brain tumor stem cells. Current Probl Cancer 2008;32:124-142
21. Louwman WJ, Voogd AC, van Dijck JA, et al. On the rising trends of incidence and prognosis for breast cancer patients diagnosed 1975-2004: a long-term population-based study in southeastern Netherlands. Cancer Causes Control 2008;19:97-106
22. Birgisson H, Talback M, Gunnarsson U, et al. Improved survival in cancer of the colon and rectum in Sweden. Eur J Surg Oncol 2005;31:845-853
23. Molina JR, Adjei AA, Jett JR. Advances in chemotherapy of non-small cell lung cancer. Chest 2006;130:1211-1219
24. Spiegel BM, Esrailian E, Laine L, et al. Clinical impact of adjuvant chemotherapy in glioblastoma multiforme: a meta-analysis. CNS Drugs 2007;21:775-787
25. Hoelzinger DB, Demuth T, Berens ME. Autocrine factors that sustain glioma invasion and paracrine biology in the brain microenvironment. J Natl Cancer Inst 2007;99:1583-1593
26. Sabel M, Giese A. Safety profile of carmustine wafers in malignant glioma: a review of controlled trials and a decade of clinical experience. Curr Med Res Opin 2008;24:3237-3239
27. LaRocca R, Glisson S, Hargis J, et al. High-grade glioma treated with surgery, carmustine wafer, postoperative radiation, and procarbazine, lomustine, and vincristine chemotherapy. Neurosurg Q 2005;15:167-171
28. Sampath P, Sungarian A, Alderson L, et al. BCNU-impregnated wafers (Gliadel) plus irinotecan (Camptosar) in combination treatment for patients with recurrent glioblastoma multiforme [abstract]. Annual Meeting of the Congress of Neurological Surgeons, Boston, MA 2005
29. Limentani SA, Asher A, Heafner M, et al. A phase I trial of surgery, Gliadel wafer implantation, and immediate postoperative carboplatin in combination with radiation therapy for primary anaplastic astrocytoma or glioblastoma multiforme. Journal of neuro-oncology 2005;72:241-244
30. Weingart J, Grossman SA, Carson KA, et al. Phase I trial of polifeprosan 20 with carmustine implant plus continuous infusion of intravenous O6-benzylguanine in adults with recurrent malignant glioma: new approaches to brain tumor therapy CNS consortium trial. J Clin Oncol 2007;25:399-404
31. Sampath P, Weaver Jr. CE, Alderson L, et al. Consecutive use of brachytherapy (Gliasite) and intratumoral chemotherapy (Gliadel) for recurrent glioblastoma: a phase I/II study with independent clinical review [abstract]. Annual Meeting of the Congress of Neurological Surgeons, Boston, MA 2005
32. Darakchiev BJ, Albright RE, Breneman JC, et al. Safety and efficacy of permanent iodine-125 seed implants and carmustine wafers in patients with recurrent glioblastoma multiforme. J Neurosurg 2008;108:236-242
33. Smith KA, Ashby L, Gonzolas F. Gross total resection (GTR) with Gliadel® wafer implantation followed by post-operative Gamma Knife™ radiosurgery and adjuvant fractionated radiotherapy for newly diagnosed GBM: phase I/II study of safety and efficacy in 30 consecutive patients [abstract]. Annual Meeting of the Congress of Neurological Surgeons, Chicago, IL 2006
34. Ryken T, Carlisle T, Buatti J, et al. Treatment of adults with newly diagnosed glioblastoma multiforme or anaplastic astrocytoma with surgery, gliadel wafers and limited field radiation plus concomitant temozolomide followed by adjuvant temozolomide [abstract]. J Clin Oncol 2008;26:13003
35. Gururangan S, Cokgor L, Rich JN, et al. Phase I study of Gliadel wafers plus temozolomide in adults with recurrent supratentorial high-grade gliomas. Neuro Oncol 2001;3:246-250
36. LaRocca RV, Hodes J, Villanueva WG, et al. A phase II study of radiation with concomitant and then sequential temozolomide (TMZ) in patients with newly diagnosed supratentorial high-grade malignant glioma who have undergone surgery with carmustine (BCNU) wafer insertion (abstract TA-28). Neuro Oncol 2006;8:445
37. Asher AL. Prospective analysis of temozolomide as adjuvant to Gliadel and radiation in newly diagnosed malignant glioma [abstract]. American Association of Neurological Surgeons 75th Annual Meeting 2007 April 14, 2007:A42860
38. Heery CR, Desjardins A, Quinn JA, et al. Acute toxicity analysis of patients receiving surgery, Gliadel wafer implantation, and postoperative daily temozolomide with radiation therapy for primary high-grade glioma [abstract]. J Clin Oncol 2006;24(18S):11504
39. Pan E, Mitchell SB, Tsai JS. A retrospective study of the safety of BCNU wafers with concurrent temozolomide and radiotherapy and adjuvant temozolomide for newly diagnosed glioblastoma patients. Journal Neurooncol 2008;88:353-357
40. Rich JN, Affronti ML, Day JM, et al. Overall survival of primary glioblastoma (GBM) patients receiving carmustine (BCNU) wafers followed by radiation (RT) and concurrent temozolomide (TMZ) plus rotational multi-agent chemotherapy [abstract]. J Clin Oncol 2007;25(18S):2070
41. Loghin ME, Prados MD, Wen P, et al. Phase I study of temozolomide and irinotecan for recurrent malignant gliomas in patients receiving enzyme-inducing antiepileptic drugs: a north american brain tumor consortium study. Clin Cancer Res 2007;13:7133-7138
42. Terasaki M, Bouffet E, Katsuki H, et al. Pilot trial of the rate of response, safety, and tolerability of temozolomide and oral VP-16 in patients with recurrent or treatment-induced malignant central nervous system tumors. Surg Neurol 2008;69:46-50
43. Zustovich F, Cartei G, Ceravolo R, et al. A phase I study of cisplatin, temozolomide and thalidomide in patients with malignant brain tumors. Anticancer Res 2007;27:1019-1024
44. Brandes AA, Stupp R, Hau P, et al. EORTC Study 26041-22041: phase I/II study on concomitant and adjuvant temozolomide (TMZ) and radiotherapy (RT) with or without PTK787/ZK222584 (PTK/ZK) in newly diagnosed glioblastoma - results of a phase I trial [abstract]. J Clin Oncol 2007;25:A2026
45. Brown PD, Krishnan S, Sarkaria J, et al. A phase II trial (N0177) of erlotinib and temozolomide (TMZ) combined with radiation therapy (RT) in glioblastoma multiforme (GBM) [abstract]. J Clin Oncol 2008;26:A2016
46. Quinn JA, Desjardins A, Weingart J, et al. Phase I trial of temozolomide plus O6-benzylguanine for patients with recurrent or progressive malignant glioma. J Clin Oncol 2005;23:7178-7187
47. Quinn JA, Jiang XS, Rich JN, et al. Phase I trial of temozolomide plus O6-benzylguanine on three different 5-day temozolomide regimens for patients with progressive glioblastoma multiforme. J Clin Oncol 2008;26:A2084
48. Sampson JH, Archer GE, Bigner DD, et al. Effect of EGFRvIII-targeted vaccine (CDX-110) on immune response and TTP when given with simultaneous standard and continuous temozolomide in patients with GBM [abstract]. J Clin Oncol 2008;26:A2011
49. Stupp R, Goldbrunner R, Neyns B, et al. Phase I/IIa trial of cilengitide (EMD121974) and temozolomide with concomitant radiotherapy, followed by temozolomide and cilengitide maintenance therapy in patients (pts) with newly diagnosed glioblastoma (GBM) [abstract]. J Clin Oncol 2007;25:A2000
50. Reardon DA, Quinn JA, Rich JN, et al. Phase I trial of irinotecan plus temozolomide in adults with recurrent malignant glioma. Cancer 2005;104:1478-1486
51. Fountzilas G, Karkavelas G, Kalogera-Fountzila A, et al. Postoperative combined radiation and chemotherapy with temozolomide and irinotecan in patients with high-grade astrocytic tumors. A phase II study with biomarker evaluation. Anticancer research 2006;26(6C):4675-4686
52. Groves MD, Puduvalli VK, Chang SM, et al. A North American brain tumor consortium (NABTC 99-04) phase II trial of temozolomide plus thalidomide for recurrent glioblastoma multiforme. J Neurooncol 2007;81:271-277
53. Riva M, Imbesi F, Beghi E, et al. Temozolomide and thalidomide in the treatment of glioblastoma multiforme. Anticancer Res 2007;27:1067-1071
54. Dresemann A, Hobbold A, Dresemann G. Bevacizumab (B) plus irinotecan (I) in progressive multiple pretreated and temozolomide (T) refractory glioblastoma multiforme (GBM): a single center experience using a low dose regimen [abstract]. J Clin Oncol 2008;26:A13007
55. Wagner SA, Desjardins A, Reardon DA, et al. Update on survival from the original phase II trial of bevacizumab and irinotecan in recurrent malignant gliomas [abstract]. J Clin Oncol 2008;26:A2021
56. Rich JN, Desjardins A, Sathornsumetee S, et al. Phase II study of bevacizumab and etoposide in patients with recurrent malignant glioma [abstract]. J Clin Oncol 2008;26:A2022
57. Sathornsumetee S, Vredenburgh JJ, Rich JN, et al. Phase II study of bevacizumab and erlotinib in patients with recurrent glioblastoma multiforme [abstract]. J Clin Oncol 2008;26:A13008
58. Reardon DA, Quinn JA, Vredenburgh JJ, et al. Phase 1 trial of gefitinib plus sirolimus in adults with recurrent malignant glioma. Clin Cancer Res 2006;12(3 Pt 1):860-868
59. Doherty L, Gigas DC, Kesari S, et al. Pilot study of the combination of EGFR and mTOR inhibitors in recurrent malignant gliomas. Neurology 2006;67:156-158
60. Phuphanich S, Rudnick J, Chu R, et al. A phase I trial of gefitinib and sirolimus in adults with recurrent glioblastoma multiforme (GBM) [abstract]. J Clin Oncol 2008;26:A2088
61. Brem H, Piantadosi S, Burger PC, et al. Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. The Polymer-brain Tumor Treatment Group. Lancet 1995;345:1008-1012
62. Westphal M, Hilt DC, Bortey E, et al. A phase 3 trial of local chemotherapy with biodegradable carm-ustine (BCNU) wafers (Gliadel wafers) in patients with primary malignant glioma. Neuro Oncol 2003;5:79-88
63. Stupp R, Mason WP, van den Bent MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005;352:987-996
64. Brem H, Ewend MG, Piantadosi S, et al. The safety of interstitial chemotherapy with BCNU-loaded polymer followed by radiation therapy in the treatment of newly diagnosed malignant gliomas: phase I trial. J Neurooncol 1995;26:111-123
65. CBTRUS. Statistical Report: Primary Brain Tumors in the United States, 1998-2002. 2005-2006. Available at: http://www.cbtrus.org/reports//2005-2006/ report.pdf. Accessed November 20, 2008.
66. Westphal M, Ram Z, Riddle V, et al. Gliadel wafer in initial surgery for malignant glioma: long-term follow-up of a multicenter controlled trial. Acta Neurochir (Wien) 2006;148:269-275
67. Zamorano L, Li Q, Levin K, et al. Brachytherapy with I-125 permanent implant combined with sequential gliadel in the treatment of GBM: a novel approach. Abstract presented at the annual meeting of the American Association of Neurological Surgeons, New Orleans, LA, April 16-21, 2005 Available at http://wwwaansorg/Library/Articleaspx?ArticleId=24746 Accessed October 6, 2005
68. Bota DA, Taylor SA. Retrospective analysis of temozolomide (TMZ) plus BCNU wafers and TMZ alone in the primary treatment of glioblastoma multiforme [abstract]. J Clin Oncol 2006;24(18S):11519
69. Tozer K, Silbergeld DL, Rostomily RC, et al. Concomitant use of Gliadel and permanent low-activity I-125 seed implants for recurrent malignant glioma Abstract presented at the annual meeting of the Congress of Neurological Surgeons, Denver, CO, 2003 Available at: http://abstractsneurosurgeonorg/view- php?id=10536 Accessed October 6, 2005
70. Foltz GD, Spence A, Stelzer K, et al. Combined treatment of recurrent glioblastoma with Gliadel Wafers and iodine-125 seeds. Annual Meeting of the Congress of Neurological Surgeons, San Diego, CA, 2001
71. Lawson DH, Phuphanich S, McKenzie E, et al. Phase I analysis of systemic interferon alpha utilized with gliadel in adults with recurrent glioblastoma multiforme (GBM) [abstract]. J Clin Oncol 2006;24(18S):11508
72. Quinn JA, Vredenburgh JJ, Rich JN, et al. Phase II trial of Gliadel plus O6-benzylguanine (O6-BG) for patients with recurrent glioblastoma multiforme [abstract]. J Clin Oncol 2006;24(18S):1568
73. Zeltzer PM, Black KL, Adamson P, et al. A phase 1/2 feasibility trial of surgery, Gliadel® Wafer and neoadjuvant continuous infusion vincristine (CIV) for patients with recurrent or progressive anaplastic astrocytoma or glioblastoma multiforme. Annual Meeting of the Society of Neuro-oncology, 2002
74. Balana C, Lopez-Pousa A, Berrocal A, et al. Phase II study of temozolomide and cisplatin as primary treatment prior to radiotherapy in newly diagnosed glioblastoma multiforme patients with measurable disease. A study of the Spanish Medical Neuro-Oncology Group (GENOM). J Neurooncol 2004;70:359-369
75. Raizer JJ, Malkin MG, Kleber M, et al. Phase 1 study of 28-day, low-dose temozolomide and BCNU in the treatment of malignant gliomas after radiation therapy. Neuro Oncol 2004;6:247-252
76. Chang SM, Prados MD, Yung WK, et al. Phase II study of neoadjuvant 1, 3-bis (2-chloroethyl)-1-nitrosourea and temozolomide for newly diagnosed anaplastic glioma: a North American Brain Tumor Consortium Trial. Cancer 2004;100:1712-1716
77. Vogelbaum MA, Sampson JH, Kunwar S, et al. Convection-enhanced delivery of cintredekin besudotox (interleukin-13-PE38QQR) followed by radiation therapy with and without temozolomide in newly diagnosed malignant gliomas: phase 1 study of final safety results. Neurosurgery 2007;61:1031-7; disscussion 7-8
78. Herrlinger U, Rieger J, Koch D, et al. Phase II trial of lomustine plus temozolomide chemotherapy in addition to radiotherapy in newly diagnosed glioblastoma: UKT-03. J Clin Oncol 2006;24:4412-4417
79. Tafuto S, Muto P, Tortoriello A, et al. Phase I study of temozolomide and lomustine in the treatment of high grade malignant glioma. Front Biosci 2006;11:502-505
80. Newlands ES, Foster T, Zaknoen S. Phase I study of temozolamide (TMZ) combined with procarbazine (PCB) in patients with gliomas. Br J Cancer 2003;89:248-251
81. Butowski N, Prados MD, Lamborn KR, et al. A phase II study of concurrent temozolomide and cis-retinoic acid with radiation for adult patients with newly diagnosed supratentorial glioblastoma. Int J Radiat Oncol Biol Phys 2005;61:1454-1459
82. Chang SM, Lamborn KR, Malec M, et al. Phase II study of temozolomide and thalidomide with radiation therapy for newly diagnosed glioblastoma multiforme. Int J Radiat Oncol Biol Phys 2004;60:353-357
83. Baumann F, Bjeljac M, Kollias SS, et al. Combined thalidomide and temozolomide treatment in patients with glioblastoma multiforme. J Neurooncol 2004;67:191-200
84. Prados MD, Yung WK, Fine HA, et al. Phase 2 study of BCNU and temozolomide for recurrent glioblastoma multiforme: North American Brain Tumor Consortium study. Neuro Oncol 2004;6:33-37
85. Brandes AA, Basso U, Reni M, et al. First-line chemotherapy with cisplatin plus fractionated temozolomide in recurrent glioblastoma multiforme: a phase II study of the Gruppo Italiano Cooperativo di Neuro-Oncologia. J Clin Oncol 2004;22:1598-1604
86. Silvani A, Eoli M, Salmaggi A, et al. Phase II trial of cisplatin plus temozolomide, in recurrent and progressive malignant glioma patients. J Neurooncol 2004;66:203-208
87. Prados MD, Lamborn KR, Chang S, et al. Phase 1 study of erlotinib HCl alone and combined with temozolomide in patients with stable or recurrent malignant glioma. Neuro Oncol 2006;8:67-78
88. Korones DN, Benita-Weiss M, Coyle TE, et al. Phase I study of temozolomide and escalating doses of oral etoposide for adults with recurrent malignant glioma. Cancer 2003;97:1963-1968
89. Korones DN, Smith A, Foreman N, et al. Temozolomide and oral VP-16 for children and young adults with recurrent or treatment-induced malignant gliomas. Pediatr Blood Cancer 2006;47:37-41
90. Gruber ML, Buster WP. Temozolomide in combination with irinotecan for treatment of recurrent malignant glioma. Am J Clin Oncol 2004;27:33-38
91. Groves MD, Puduvalli VK, Conrad CA, et al. Phase II trial of temozolomide plus marimastat for recurrent anaplastic gliomas: a relationship among efficacy, joint toxicity and anticonvulsant status. J Neurooncol 2006;80:83-90
92. Jaeckle KA, Hess KR, Yung WK, et al. Phase II evaluation of temozolomide and 13-cis-retinoic acid for the treatment of recurrent and progressive malignant glioma: a North American Brain Tumor Consortium study. J Clin Oncol 2003;21:2305-2311
93. Spence AM, Peterson RA, Scharnhorst JD, et al. Phase II study of concurrent continuous Temozolomide (TMZ) and Tamoxifen (TMX) for recurrent malignant astrocytic gliomas. J Neurooncol 2004;70:91-95
94. Rabbani G, Benzil D, Wallam MN, et al. Combination therapy with thalidomide, temozolomide and tamoxifen improves quality of life in patients with malignant astrocytomas. Anticancer Res 2007;27:2729-2736
95. Mayer TM, Lacy J, Baehring J. A single institution's experience with bevacizumab and cytoxic chemotherapy in progressive malignant glioma [abstract]. J Clin Oncol 2008;26(Suppl):A13010
96. Lassen U, Hasselbalch B, Sørensen M, et al. A phase II trial with cetuximab, bevacizumab, and irinotecan for patients with primary glioblastomas and progression after radiation therapy and temozolamide. J Clin Oncol 2008;26:A2056
97. Vredenburgh JJ, Desjardins A, Herndon JE, 2nd, et al. Phase II trial of bevacizumab and irinotecan in recurrent malignant glioma. Clin Cancer Res 2007;13:1253-1259
98. Gil Gil MJ, Martinez-Garcia M, Reynes G, et al. Combination of bevacizumab plus irinotecan in recurrent malignant gliomas (MG): a retrospective study of efficacy and safety [abstract]. J Clin Oncol 2008;26:A13011
99. Zuniga RM, Torcuator R, Doyle T, et al. Retrospective analysis of patterns of recurrence seen on MRI in patients with recurrent glioblastoma multiforme treated with bevacizumab plus irinotecan [abstract]. J Clin Oncol 2008;26:A13013
100. Sathornsumetee S, Cao Y, Marcello JE, et al. Tumor angiogenic and hypoxic profiles predict radiographic response and survival in malignant astrocytoma patients treated with bevacizumab and irinotecan. J Clin Oncol 2008;26:271-278
101. Vredenburgh JJ, Desjardins A, Herndon JE, 2nd, et al. Bevacizumab plus irinotecan in recurrent glioblastoma multiforme. J Clin Oncol 2007;25:4722-4729
102. Updated CDX-110 data in glioblastoma multiforme presented at 44th annual ASCO annual meeting Business Wire, 2008
103. Avgeropoulos NG, Batchelor TT. New treatment strategies for malignant gliomas. Oncologist 1999;4:209-224