Repeat craniotomy and Bevacizumab have shown to be beneficial in the recurrent setting.3 Despite this, about 60% of patients relapse on Bevacizumab, can have serious side effects, develop resistance to the drug, and also fail to respond to any further chemotherapy.4 In 2012, Stupp et al published their results on the first Phase III trial of 237 patients studying the effects of TTFs alone, compared with standard chemotherapy regimens in recurrent GBM.5 Thirty-six patients received bevacizumab, 36 received nitrosureas
, 12 received temozolomide, and 33 received other agents.
Table 3: Standard Chemotherapies with Known Nephrotoxicity Risk Carboplatin Cisplatin Cyclophosphamide Gemcitabine Methotrexate Mitomycin Nitrosureas
Pemetrexed Streptozocin Vinca alkaloids
1) Alkylating agents include the nitrogen mustards (eg cyclophosphamide), nitrosureas
(lomustine), platinum compounds (cisplatin) and a variety of others (eg busulfan, temozolomide).
Otros estudios retrospectivos han sugerido que la perdida de 1p/19q tambien predice la quimiosensibilidad a agentes de alquilacion (nitrosureas
y temozolamida) en gliomas de bajo grado .
Examples of nitrosureas
are Carmustine, Lomustine and Streptozocin.
The most commonly used chemotherapy drugs have been alkylating agents, such as procarbazine (Matulane), temozolomide (Temodar), and the nitrosureas
, carmustine (BCNU) and lomustine (CCNU).