Summary
A combination of cisplatin and cytosine arabinoside was used to treat 21 patients with glioblastomas and 5 patients with recurrent grade 11 gliomas. Cisplatin 60–100 mg/m2 was given I.V. in 250 ml 0.45% saline and preceded by 500 ml dextrose 5% in 0.45% saline. Mannitol 50 g was given I.V. concurrently with the cisplatin. Cytosine arabinoside 500–1000 mg/m2 was given by rapid I.V. infusion immediately after the cisplatin. Of 25 evaluable patients, 10 (40%) experienced objective tumor shrinkage on CT scan, and 6 (24%) stabilized. There were 2 complete remissions. Patients who had had no prior treatment had a higher response rate (58%) than those previously treated (23%). Myelosuppression occurred in some patients 2–3 weeks after treatment. Gastrointestinal toxicity (vomiting and diarrhea) was dose-limiting. Two patients had possible neurological toxicity. Recommended doses for further studies are cisplatin 90 mg/m2 and cytosine arabinoside 900 mg/m2.
Similar content being viewed by others
References
Walker MD, Green SB, Byar DP, Alexander E, Batzdorf U, Brooks WH, Hunt WE, MacCarty CS, Mahaley MS Jr, Maeley J Jr, Owens G, Ramsohoff J, Robertson JT, Shapiro WR, Smith KR Jr, Wilson CB, Strike TA: Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. New Engl J Med 23:1323–1329, 1980.
Khan A, D'Souza B, Wharam M, Sinks L, Woo S, McCullough D, Leventhal BG: Cisplatinum in recurrent brain tumors. Proc Amer Soc Clin Oncol 22:402, 1981.
Leventhal BG, Freeman A: Cis-diamminedichloroplatinum: a phase II study in pediatric malignancies. Proc Amer Assoc Cancer Res 20:197, 1979.
Stewart DJ, O'Bryan RM, Al-Sarraf M, Costanzi JJ, Oishi N: Phase II study of cisplatin in recurrent astrocytomas in adults: a southwest oncology group study. J Neuro-Oncol 1:145–147, 1983.
Rozencweig M, Von Hoff DD, Slavik N, Muggia F: Cis-diamminedichloroplatinum: a new anticancer drug. Ann Intern Med 86:803–812, 1977.
Kolaric K, Roth A, Pavelic Z: Phase II clinical trials of cis-dichlorodiammine platinum (cis DDP) in metastatic brain tumors. Proc Amer Soc Clin Oncol 1:183, 1982.
Stewart DJ, Leavens M, Maor M, Feun L, Luna M, Bonura J, Caprioli R, Loo TL, Benjamin RS: Human central nervous system distribution of cis-diamminedichloroplatinum and use as a radiosensitizer in malignant brain tumors. Cancer Res 42:2472–2479, 1982.
Hill MM, Loeb E, MacLellan A, Hill NO, Khan A, King JJ: Clinical studies of platinum coordination compounds in the treatment of various malignant diseases. Cancer Chemother Rep 59:647–659, 1975.
Stewart DJ, Leavens M, Friedman J, Benjamin RS, Moore EC, Bodey GP, Valdivieso M, Burgess MA, Wiseman C, Loo TL: Penetration of N-(phosphonacetyl)-L-aspartate into human central nervous system and intracerebral tumor. Cancer Res 40:3163–3166, 1980.
Stewart DJ, Benvenuto JA, Leavens M, Hall SW, Benjamin RS, Plunkett W, McCredie, KD, Burgess MA, Loo TL: Penetration of 3-deazauridine into human brain, intracerebral tumor, and cerebrospinal fluid. Cancer Res 39: 4119–4122, 1979.
Stewart DJ, Lu L, Benjamin RS, Leavens M, Luna M, Yap HY, Loo TL: Concentrations of vinblastine in human intracerebral tumor and other tissues. J Neuro-Oncol 1:139–144, 1983.
Rosenblum M, Stewart DJ, Yap BS, Leavens M, Benjamin RS, Loo TL: Penetration of methylglyoxal bis(guanylhydrazone) into intracerebral tumors in humans. Cancer Res 41:459–462, 1981.
Savaraj N, Lu K, Feun LG, Leavens ME, Stewart DJ, Burgess MA, Benjamin RS, Loo TL: Intracerebral penetration and tissue distribution of 2,5-diaziridinyl 3,6-bis (carboethoxyamino) 1,4-benzoquinone (AZQ NSC 182986). J Neuro-Oncol 1:15–20, 1983.
Bergerat JP, Drewinko B, Corry P, Barlogie B, Ho DH: Synergistic lethal effect of cis-dichlorodiammineplatinum and 1-B-D-arabinofuranosylcytosine. Cancer Res 41:25–30, 1981.
Bogdahn U: Chemosensitivity of malignant human brain tumors: preliminary results. J Neuro-Oncol 1:149–166, 1983.
Feun LG, Stewart DJ, Maor M, Leavens M, Savaraj N, Burgess MA, Yung WKA, Benjamin RS: A pilot study of cis-diamminedichloroplatinum and radiation therapy in patients with high grade astrocytomas. J Neuro-Oncol 1:109–113, 1983.
Stewart DJ, Feun LG, Maor M, Leavens M, Burgess MA, Benjamin RS, Bodey GP Sr: Weekly cisplatin during cranial irradiation for malignant melanoma metastatic to brain. J Neuro-Oncol 1:49–52, 1983.
Douple EB et al: Therapeutic potentiation in a mouse mammary tumor and an intracerebral rat brain tumor by combined treatment with cis-dichlorodiammine platinum-II and radiation. J Clin Hematol and Oncol 7:585–603, 1977.
Stewart DJ, Benjamin RS, Luna M, Seifert WE, Loo TL: Human tissue distribution of platinum after cis-diammine-dichloroplatinum. Cancer Chemother & Pharm 10:51–54, 1982.
Kyriazis AP, Kyriazis AA, Martelo AJ: Response to Single agent and combination chemotherapy of a human pancreatic carcinoma grown in nude mice. Proc Amer Assoc Cancer Res 22:211, 1981.
Stewart DJ, Wallace S, Feun L, Leavens M, Young SE, Handel S, Mavligit G, Benjamin RS: Intracarotid artery infusion of cis-diamminedichloroplatinum: Phase I study in patients with recurrent malignant intracerebral tumors. Cancer Res 42:2059–2062, 1982.
Feun L, Stewart DJ, Wallace S, Leavens M, Savaraj N Burgess MA, Young S, Benjamin RS: Phase I-II trial of intracarotid (IC) cis-diamminedichloroplatinum (DDP) in patients with intracerebral tumors (ICT). Proc Am See Clin Oncol 1:197, 1982.
Stewart DJ, Benjamin RS, Zimmerman S, Capriolo RM, Wallace W, Chuang V, Calvo D III, Samuels M, Bonura J, Loo TL: Clinical pharmacology of intra-arterial cis-diamminedichloroplatinum (II). Cancer Res 43:917–920, 1983.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Stewart, D.J., Richard, M.T., Benoit, B. et al. Cisplatin plus cytosine arabinoside in adults with malignant gliomas. J Neuro-Oncol 2, 29–34 (1984). https://doi.org/10.1007/BF00165155
Issue Date:
DOI: https://doi.org/10.1007/BF00165155