Scherm, Angelika and Ippen, Franziska Maria and Hau, Peter and Baurecht, Hansjoerg and Wick, Wolfgang and Gempt, Jens and Knuettel, Helge and Leitzmann, Michael F. and Seliger, Corinna (2023) Targeted therapies in patients with newly diagnosed glioblastoma-A systematic meta-analysis of randomized clinical trials. INTERNATIONAL JOURNAL OF CANCER, 152 (11). pp. 2373-2382. ISSN 0020-7136, 1097-0215
Full text not available from this repository. (Request a copy)Abstract
Glioblastoma (GB) is the most common malignant primary brain tumor in adults. The standard of care for newly diagnosed GB involves surgical resection followed by radiochemotherapy with temozolomide, with or without tumor-treating fields. In recent years, various efforts have been made to identify suitable molecularly targeted treatment options for malignant brain tumors. This meta-analysis provides an overview of recently published randomized controlled trials (RCTs) with and without molecular stratification, analyzing targeted agents in patients with newly diagnosed GB. The Cochrane Library, MEDLINE (Ovid), , WHO's International Clinical Trials Registry Platform, and Google Scholar were searched for RCTs on targeted therapies in patients with newly diagnosed glioblastoma. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were extracted and pooled in a random-effects meta-analysis. Twelve RCTs (n = 3941 patients) involving protein kinase inhibitors, proteasome and histone deacetylase inhibitors, anti-angiogenic approaches and poly (ADP-ribose) polymerase (PARP) inhibitors were included in the meta-analysis. None of the targeted agents achieved a significant benefit with regard to OS (HR = 0.98 [95% confidence interval (CI) 0.86-1.11, P = .7731]). By comparison, targeted therapy showed a benefit for PFS (HR = 0.83 [95% CI 0.74-0.94, P = .0037]), especially for patients with an unmethylated O6-methylguanine-DNA-methyltransferase (MGMT) promoter (0.75 [95% CI 0.56-0.99, P = .0440]). Prolongation of PFS was largely driven by VEGF inhibition with bevacizumab (HR = 0.70 [95% CI 0.61-0.80, P = .0000]). VEGF inhibition with bevacizumab prolonged PFS in patients with newly diagnosed glioblastoma compared to standard care. However, no improvement in OS was observed with any of the targeted agents.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PHASE-II TRIAL; RADIATION-THERAPY; STANDARD TREATMENT; PLUS RADIOTHERAPY; OPEN-LABEL; TEMOZOLOMIDE; BEVACIZUMAB; COMBINATION; CHEMORADIATION; MULTICENTER; glioblastoma; meta-analysis; newly diagnosed; randomized trials; targeted agents |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurologie Medicine > Institut für Epidemiologie und Präventivmedizin Central Institutions > University Library |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 12 Mar 2024 12:05 |
| Last Modified: | 12 Mar 2024 12:05 |
| URI: | https://pred.uni-regensburg.de/id/eprint/59742 |
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