Talampanel with standard radiation and temozolomide in patients with newly diagnosed glioblastoma: A multicenter phase II trial

Stuart A Grossman, Xiaobu Ye, Marc Chamberlain, Tom Mikkelsen, Tracy Batchelor, Serena Desideri, Steven Piantadosi, Joy Fisher, Howard A. Fine

Research output: Contribution to journalArticle

Abstract

Recent data suggest that the glutamatergic system is important in the proliferation and migration of glioblastoma. Talampanel is a well-tolerated, oral α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor blocker that could be beneficial in this disease. Patients and Methods: This trial was designed to estimate overall survival in adults with newly diagnosed glioblastoma treated with talampanel in addition to standard radiation (RT) and temozolomide (TMZ). A secondary purpose was to evaluate talampanel toxicity in this setting. Talampanel was initiated with RT + TMZ and discontinued for toxicity or disease progression. Survival was compared with historical controls. Results: Seventy-two patients were enrolled from December 2005 to July 2006. Their median age was 60 years (range, 37 to 85 years, with 17% > 70 years), median Karnofsky performance score was 90 (range, 70 to 100), and 77% had a debulking procedure. With a median follow-up time of 18 months, 55 patients (76%) have died, yielding a median survival time of 18.3 months (95% CI, 14.6 to 22.5 months). When the 60 patients who were 18 to 70 years old were compared with the European Organisation for Research and Treatment of Cancer (EORTC) RT + TMZ data, the median survival (20.3 v 14.6 months, respectively) and percentage of patients surviving at 24 months (41.7% v 26.5%, respectively; P = .02) seemed superior. The percentage of patients methylated at O6-methylguanine-DNA methyltransferase was lower than on the EORTC study (29% v 43%, respectively). Talampanel was well tolerated and did not increase the known hematologic or nonhematologic toxicities of TMZ. Conclusion Talampanel can be added to RT + TMZ without significant additional toxicity. The encouraging survival results in methylated and unmethylated patients suggest that blocking AMPA receptors may be a useful strategy in newly diagnosed glioblastoma.

Original languageEnglish (US)
Pages (from-to)4155-4161
Number of pages7
JournalJournal of Clinical Oncology
Volume27
Issue number25
DOIs
StatePublished - Sep 1 2009

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temozolomide
GYKI 53405
Glioblastoma
Radiation
Survival
AMPA Receptors
Methyltransferases
Disease Progression

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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Talampanel with standard radiation and temozolomide in patients with newly diagnosed glioblastoma : A multicenter phase II trial. / Grossman, Stuart A; Ye, Xiaobu; Chamberlain, Marc; Mikkelsen, Tom; Batchelor, Tracy; Desideri, Serena; Piantadosi, Steven; Fisher, Joy; Fine, Howard A.

In: Journal of Clinical Oncology, Vol. 27, No. 25, 01.09.2009, p. 4155-4161.

Research output: Contribution to journalArticle

Grossman, Stuart A ; Ye, Xiaobu ; Chamberlain, Marc ; Mikkelsen, Tom ; Batchelor, Tracy ; Desideri, Serena ; Piantadosi, Steven ; Fisher, Joy ; Fine, Howard A. / Talampanel with standard radiation and temozolomide in patients with newly diagnosed glioblastoma : A multicenter phase II trial. In: Journal of Clinical Oncology. 2009 ; Vol. 27, No. 25. pp. 4155-4161.
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abstract = "Recent data suggest that the glutamatergic system is important in the proliferation and migration of glioblastoma. Talampanel is a well-tolerated, oral α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor blocker that could be beneficial in this disease. Patients and Methods: This trial was designed to estimate overall survival in adults with newly diagnosed glioblastoma treated with talampanel in addition to standard radiation (RT) and temozolomide (TMZ). A secondary purpose was to evaluate talampanel toxicity in this setting. Talampanel was initiated with RT + TMZ and discontinued for toxicity or disease progression. Survival was compared with historical controls. Results: Seventy-two patients were enrolled from December 2005 to July 2006. Their median age was 60 years (range, 37 to 85 years, with 17{\%} > 70 years), median Karnofsky performance score was 90 (range, 70 to 100), and 77{\%} had a debulking procedure. With a median follow-up time of 18 months, 55 patients (76{\%}) have died, yielding a median survival time of 18.3 months (95{\%} CI, 14.6 to 22.5 months). When the 60 patients who were 18 to 70 years old were compared with the European Organisation for Research and Treatment of Cancer (EORTC) RT + TMZ data, the median survival (20.3 v 14.6 months, respectively) and percentage of patients surviving at 24 months (41.7{\%} v 26.5{\%}, respectively; P = .02) seemed superior. The percentage of patients methylated at O6-methylguanine-DNA methyltransferase was lower than on the EORTC study (29{\%} v 43{\%}, respectively). Talampanel was well tolerated and did not increase the known hematologic or nonhematologic toxicities of TMZ. Conclusion Talampanel can be added to RT + TMZ without significant additional toxicity. The encouraging survival results in methylated and unmethylated patients suggest that blocking AMPA receptors may be a useful strategy in newly diagnosed glioblastoma.",
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AU - Mikkelsen, Tom

AU - Batchelor, Tracy

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AU - Fisher, Joy

AU - Fine, Howard A.

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