Effectiveness of interferon-beta and temozolomide combination therapy against temozolomide-refractory recurrent anaplast
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Open Access
Case report
Effectiveness of interferon-beta and temozolomide combination therapy against temozolomide-refractory recurrent anaplastic astrocytoma Takamitsu Fujimaki*1, Hisato Ishii2, Akira Matsuno1, Hajime Arai2 and Tadayoshi Nakagomi1 Address: 1Department of Neurosurgery, Teikyo University School of Medicine, Tokyo, Japan and 2Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan Email: Takamitsu Fujimaki* - [email protected]; Hisato Ishii - [email protected]; Akira Matsuno - [email protected]; Hajime Arai - [email protected]; Tadayoshi Nakagomi - [email protected] * Corresponding author
Published: 4 August 2007 World Journal of Surgical Oncology 2007, 5:89
doi:10.1186/1477-7819-5-89
Received: 27 February 2007 Accepted: 4 August 2007
This article is available from: http://www.wjso.com/content/5/1/89 © 2007 Fujimaki et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Malignant gliomas recur even after extensive surgery and chemo-radiotherapy. Although a relatively novel chemotherapeutic agent, temozolomide (TMZ), has demonstrated promising activity against recurrent glioma, the effects last only a few months and drug resistance develops thereafter in most cases. Induction of O6-methylguanine-DNA methyltransferase (MGMT) in tumors is considered to be responsible for resistance to TMZ. Interferon-beta has been reported to suppress MGMT in an experimental glioma model. Here we report a patient with TMZ-refractory anaplastic astrocytoma (AA) who was treated successfully with a combination of interferon-beta and TMZ. Case presentation: A patient with recurrent AA after radiation-chemotherapy and stereotactic radiotherapy was treated with TMZ. After 6 cycles, the tumor became refractory to TMZ, and the patient was treated with interferon-beta at 3 × 106 international units/body, followed by 5 consecutive days of 200 mg/m2 TMZ in cycles of 28 days. After the second cycle the tumor decreased in size by 50% (PR). The tumor showed further shrinkage after 8 months and the patient's KPS improved from 70% to 100%. The immunohistochemical study of the initial tumor specimen confirmed positive MGMT protein expression. Conclusion: It is considered that interferon-beta pre-administration increased the TMZ sensitivity of the glioma, which had been refractory to TMZ monotherapy.
Background Treatment modalities for recurrent glioma are limited. Since surgery or local radiotherapy can be applied only to limited patients, a more systemic approach such as chemotherapy is used in most cases. Until recently, however, chemotherapy has had only a limited impact for control
of recurrent glioma. A relatively novel chemotherapeutic agent, temozolomide (TMZ), has demonstrated promising ac
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