Abstract
Fotemustine (FTMS) is a third-generation nitrosourea, in preclinical studies, FTMS compared favorably with carmustine (BCNU) and lomustine (CCNU) against several human tumor cell lines. In conventional schedule, FTMS is administered at a dose of 100 mg/sqm/week for three consecutive weeks as induction (I) treatment, followed by 100 mg/sqm every three weeks, after a 5-week rest, as maintenance (M). Several Italian groups reported the results using FTMS in malignant glioma patients recurring after temozolomide standard treatment. In these papers, the 6-progression free survival are ranging from 20 to 52%. With the schedule (I + M) myelosuppression is observed in more than 30% of patients, and thrombocytopenia and leukopenia are more frequent and significant in Temozolomide pretreated patients. On the bases of the hematological toxicities several authors experimented new schedules of FTMS administrated at low doses. Recently, some authors reported the interesting results of a multicenter study on recurrent glioblastoma multiforme patients combining FTMS with new antiangiogentic agent bevacizumab.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Fischel JL, Formento P, Etienne MC et al (1990) In vitro chemosensitivity testing of fotemustine (S 10036), a new antitumor nitrosourea. Cancer Chemother Pharmacol 25:337–341
Khayat D, Lokiec F, Bizzari JP et al (1987) Phase I clinical study of the new amino acid-linked nitrosourea, S 10036, administered on a weekly schedule. Cancer Res 47:6782–6785
Frenay M, Giroux B, Khoury S, Derlon JM, Namer M (1991) Phase II study of fotemustine in recurrent supratentorial malignant gliomas. Eur J Cancer 27:852–856
Malhaire JP, Lucas B, Simon H, Person H, Dam-Hieu P, Labat JP (1989) Fotemustine (Muphoran) in 22 patients with relapses of high-grade cerebral gliomas. Bull Cancer 86:289–294
Brandes AA, Tosoni A, Franceschi E, Blatt V, Santoro A, Faedi M, Amistà P, Gardiman M, Labianca R, Bianchini C, Ermani M, Reni M (2009) Fotemustine as second-line treatment for recurrent or progressive glioblastoma after concomitant and/or adjuvant temozolomide: a phase II trial of Gruppo Italiano Cooperativo di Neuro-Oncologia (GICNO) 64:769-775
Scoccianti S, Detti B, Sardaro A, Iannalfi A, Meattini I, Leonulli BG, Borghesi S, Martinelli F, Bordi L, Ammannati F, Biti G (2008) Second-line chemotherapy with fotemustine in temozolomide-pretreated patients with relapsing glioblastoma: a single institution experience. Anticancer Drugs 19:613–620
Fabrini MG, Silvano G, Lolli I, Perrone F, Marsella A, Scotti V, Cionini L (2009) A multi-institutional phase II study on second-line Fotemustine chemotherapy in recurrent glioblastoma. J Neurooncol 92:79–86
Fabi A, Metro G, Russillo M, Vidiri A, Carapella CM, Maschio M, Cognetti F, Jandolo B, Mirri MA, Sperduti I, Telera S, Carosi M, Pace A (2009) Treatment of recurrent malignant gliomas with fotemustine monotherapy: impact of dose and correlation with MGMT promoter methylation. BMC Cancer 9:101
Addeo R, Caraglia M, De Santi MS, Montella L, Abbruzzese A, Parlato C, Vincenzi B, Carraturo M, Faiola V, Genovese M, Cennamo G, Del Prete S (2011) A new schedule of fotemustine in temozolomide-pretreated patients with relapsing glioblastoma. J Neurooncol 102:417–424
Fazeny-Dorner B, Veitlb M, Wenzela C et al (2003) Second-line chemotherapy with dacarbazine and fotemustine in nitrosourea pretreated patients with recurrent glioblastoma multiforme. Anticancer Drugs 14:437–442
Silvani A, Lamperti E, Gaviani P, Eoli M, Fiumani A, Salmaggi A, Falcone C, Filippini G, Botturi A, Boiardi A (2008) Salvage chemotherapy with procarbazine and fotemustine combination in the treatment of temozolomide treated recurrent glioblastoma patients. J Neurooncol 87:143–151
Gaviani P, Salmaggi A, Silvani A (2011) Combined chemotherapy with temozolomide and fotemustine in recurrent glioblastoma patients. J Neurooncol 104:617–618
Soffietti R, Trevisan E, Ruda R, Bertero L, Bosa C, Fabrini MG, Lolli I (2011) Phase II trial of bevacizumab with fotemustine in recurrent glioblastoma: Final results of a multicenter study of AINO (Italian Association of Neuro-oncology). J Clin Oncol 29: (suppl; abstr 2027) 2011 ASCO Annual Meeting
Conflict of interest
The authors declare that there is no conflict of interest related to the publication of this article.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Silvani, A., Gaviani, P., Lamperti, E. et al. Lecture: fotemustine in brain tumors. Neurol Sci 32 (Suppl 2), 255–257 (2011). https://doi.org/10.1007/s10072-011-0800-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-011-0800-4