Top

World Journal of Surgical Oncology

Published in:

Open Access 01-12-2007 | Case report

Effectiveness of interferon-beta and temozolomide combination therapy against temozolomide-refractory recurrent anaplastic astrocytoma

Authors: Takamitsu Fujimaki, Hisato Ishii, Akira Matsuno, Hajime Arai, Tadayoshi Nakagomi

Published in: World Journal of Surgical Oncology | Issue 1/2007

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.

Available only for authorised users

Nishikawa R, Shibui S, Maruno M, Sugiyama K, Sato S, Fujimaki T, Takahashi H, Wakabayashi T, Takahashi J, Kochi M, Nakamura H, Sawamura Y, Ikeda J, Hori T, Aoki T, Matsutani M: Efficacy and safety of monotherapy with temozolomide in patients with anaplastic astrocytoma at first relapse – a phase II clinical study. Gan To Kagaku Ryoho. 2006, 33: 1279-1285.PubMed

Yung WK, Prados MD, Yaya-Tur R, Rosenfeld SS, Brada M, Friedman HS, Albright R, Olson J, Chang SM, O'Neill AM, Friedman AH, Bruner J, Yue N, Dugan M, Zaknoen S, Levin VA: Multicenter phase II trial of temozolomide in patients with anaplastic astrocytoma or anaplastic oligoastrocytoma at first relapse. Temodal Brain Tumor Group. J Clin Oncol. 1999, 17: 2762-2771.PubMed

Hegi ME, Diserens AC, Gorlia T, Hamou MF, de Tribolet N, Weller M, Kros JM, Hainfellner JA, Mason W, Mariani L, Bromberg JE, Hau P, Mirimanoff RO, Cairncross JG, Janzer RC, Stupp R: MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med. 2005, 352: 997-1003. 10.1056/NEJMoa043331.CrossRefPubMed

Natsume A, Ishii D, Wakabayashi T, Tsuno T, Hatano H, Mizuno M, Yoshida J: IFN-beta down-regulates the expression of DNA repair gene MGMT and sensitizes resistant glioma cells to temozolomide. Cancer Res. 2005, 65: 7573-7579.PubMed

Park JA, Joe YA, Kim TG, Hong YK: Potentiation of antiglioma effect with combined temozolomide and interferon-beta. Oncol Rep. 2006, 16: 1253-1260.PubMed

Brell M, Tortosa A, Verger E, Gil JM, Vinolas N, Villa S, Acebes JJ, Caral L, Pujol T, Ferrer I, Ribalta T, Graus F: Prognostic significance of O6-Methylguanine-DNA Methyltransferase determined by promoter hypermethylation and immunohistochemical expression in anaplastic gliomas. Clin Cancer Res. 2005, 11: 5167-5174. 10.1158/1078-0432.CCR-05-0230.CrossRefPubMed

Brada M, Hoang-Xuan K, Rampling R, Dietrich PY, Dirix LY, Macdonald D, Heimans JJ, Zonnenberg BA, Bravo-Marques JM, Henriksson R, Stupp R, Yue N, Bruner J, Dugan M, Rao S, Zaknoen S: Multicenter phase II trial of temozolomide in patients with glioblastoma multiforme at first relapse. Ann Oncol. 2001, 12: 259-266. 10.1023/A:1008382516636.CrossRefPubMed

Groves MD, Puduvalli VK, Chang SM, Conrad CA, Gilbert MR, Tremont-Lukats IW, Liu TJ, Peterson P, Schiff D, Cloughesy TF, Wen PY, Greenberg H, Abrey LE, DeAngelis LM, Hess KR, Lamborn KR, Prados MD, Yung WK: 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. 10.1007/s11060-006-9225-y.CrossRefPubMed

Brandes AA, Tosoni A, Cavallo G, Bertorelle R, Gioia V, Franceschi E, Biscuola M, Blatt V, Crino L, Ermani M: Temozolomide 3 weeks on and 1 week off as first-line therapy for recurrent glioblastoma: phase II study from gruppo italiano cooperativo di neuro-oncologia (GICNO). Br J Cancer. 2006, 95: 1155-1160. 10.1038/sj.bjc.6603376.PubMedCentralCrossRefPubMed

10.

Wick W, Steinbach JP, Kuker WM, Dichgans J, Bamberg M, Weller M: One week on/one week off: a novel active regimen of temozolomide for recurrent glioblastoma. Neurology. 2004, 62: 2113-2115.CrossRefPubMed

11.

Kong DS, Lee JI, Kim WS, Son MJ, Lim do H, Kim ST, Park K, Kim JH, Eoh W, Nam DH: A pilot study of metronomic temozolomide treatment in patients with recurrent temozolomide-refractory glioblastoma. Oncol Rep. 2006, 16: 1117-1121.PubMed

12.

Kuroki M, Tanaka R, Suzuki Y, Moriyama M, Kuwabara Y, Kobayashi S: Antitumor effect of recombinant murine interferon-beta against mouse malignant glioma. J Interferon Res. 1987, 7: 301-311.CrossRefPubMed

13.

Chamberlain MC, Tsao-Wei DD, Groshen S: Salvage chemotherapy with cyclophosphamide for recurrent temozolomide-refractory anaplastic astrocytoma. Cancer. 2006, 106: 172-179. 10.1002/cncr.21582.CrossRefPubMed

14.

Kanzawa T, Bedwell J, Kondo Y, Kondo S, Germano IM: Inhibition of DNA repair for sensitizing resistant glioma cells to temozolomide. J Neurosurg. 2003, 99: 1047-1052.CrossRefPubMed

15.

Wakabayashi T, Kajita Y, Mizuno M, Nagasaka T, Yoshida J: Efficacy of adjuvant therapy with procarbazine, MCNU, and vincristine for oligodendroglial tumors. Neurol Med Chir (Tokyo). 2001, 41: 115-119. 10.2176/nmc.41.115.CrossRef

16.

Rosenblum MG, Yung WK, Kelleher PJ, Ruzicka F, Steck PA, Borden EC: Growth inhibitory effects of interferon-beta but not interferon-alpha on human glioma cells: correlation of receptor binding, 2',5'-oligoadenylate synthetase and protein kinase activity. J Interferon Res. 1990, 10: 141-151.CrossRefPubMed

17.

Hong YK, Chung DS, Joe YA, Yang YJ, Kim KM, Park YS, Yung WK, Kang JK: Efficient inhibition of in vivo human malignant glioma growth and angiogenesis by interferon-beta treatment at early stage of tumor development. Clin Cancer Res. 2000, 6: 3354-3360.PubMed

18.

Singh RK, Gutman M, Bucana CD, Sanchez R, Llansa N, Fidler IJ: Interferons alpha and beta down-regulate the expression of basic fibroblast growth factor in human carcinomas. Proc Natl Acad Sci USA. 1995, 92: 4562-4566. 10.1073/pnas.92.10.4562.PubMedCentralCrossRefPubMed

19.

Kodera T, Kubota T, Kabuto M, Nakagawa T, Takeuchi H, Arishima H, Sato K, Kobayashi H, Kitabayashi M, Hirose S: Analysis of the proliferative potential of tumor cells after stereotactic radiosurgery for recurrent astrocytic tumors. Neurol Res. 2000, 22: 802-808.PubMed

20.

Ross DA, Sandler HM, Balter JM, Hayman JA, Archer PG, Auer DL: Imaging changes after stereotactic radiosurgery of primary and secondary malignant brain tumors. J Neurooncol. 2002, 56: 175-181. 10.1023/A:1014571900854.CrossRefPubMed

21.

Graves EE, Nelson SJ, Vigneron DB, Verhey L, McDermott M, Larson D, Chang S, Prados MD, Dillon WP: Serial proton MR spectroscopic imaging of recurrent malignant gliomas after gamma knife radiosurgery. Am J Neuroradiol. 2001, 22: 613-624.PubMed

Title: Effectiveness of interferon-beta and temozolomide combination therapy against temozolomide-refractory recurrent anaplastic astrocytoma
Authors: Takamitsu Fujimaki
Hisato Ishii
Akira Matsuno
Hajime Arai
Tadayoshi Nakagomi
Publication date: 01-12-2007
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2007
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/1477-7819-5-89

At a glance: The STEP trials

Springer Medicine

Effectiveness of interferon-beta and temozolomide combination therapy against temozolomide-refractory recurrent anaplastic astrocytoma

Abstract

Background

Case presentation

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Case presentation

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2007

Primary breast lymphoma in the right breast during treatment for left breast cancer

Primary presacral neuroendocrine tumor associated with imperforate anus

Successful management of elderly breast cancer patients treated without radiotherapy

The impact of splenectomy on outcomes after distal and total pancreatectomy

Metastasis to the gluteus maximus muscle from renal cell carcinoma with special emphasis on MRI features

Analysis of single nucleotide polymorphism in the promoter and protein expression of the chemokine Eotaxin-1 in colorectal cancer patients