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Prolonged treatment with biologic agents for malignant glioma: A case study with high dose tamoxifen

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Abstract

Traditional study design for treatment of malignant gliomas does notallow tumor progression to be greater than 25–50 percent withoutterminating treatment. This design may prevent recognition of patients whobenefit from the treatment either by slowed growth or delayed response. Adelayed response or slowed growth may be characteristic of biologic agentsbeing evaluated in the treatment of malignant glioma. Because of the lowtoxicity of certain biologic drugs, continued treatment through tumor growthcan be ethically considered in study design. The effect of biologic agentson a neoplasm may include cellular differentiation, retardation of growth,cytostasis, cytocidal effects, or apoptosis. Such effects may clinicallytranslate into a complete response, partial response, stable disease orretardation of growth with or without an eventual reduction of tumor. Wepresent a patient with a recurrent malignant glioma who was continued onhigh dose tamoxifen despite radiologic documented doubling of the tumor sizeand who eventually showed a delayed response to this agent nine months afterinitiation of treatment. Strong consideration should be given to theprolonged treatment of non-toxic biologic agents in a controlled clinicaltrial, where agents have shown some benefit in phase one studies.

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Authors and Affiliations

  1. Department of Neurology, USA

    Timothy F. Cloughesy & Roger P. Woods

  2. Department of Surgery, USA

    Keith L. Black

  3. Jonsson Comprehensive Cancer Center, USA

    Timothy F. Cloughesy & Keith L. Black

  4. Neuro-Oncology Program, USA

    Timothy F. Cloughesy & Keith L. Black

  5. Division of Brain Mapping, USA

    Roger P. Woods

  6. Ucla School of Medicine and Department of Neurological Surgery, Usc and University of North Dakota, USA

    William T. Couldwell

  7. Department of Medicine, USA

    Ron E. Law

  8. Department of Pathology, Usc School of Medicine, USA

    David R. Hinton

Authors
  1. Timothy F. Cloughesy
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  2. Roger P. Woods
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  3. Keith L. Black
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  4. William T. Couldwell
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  5. Ron E. Law
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  6. David R. Hinton
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Cloughesy, T.F., Woods, R.P., Black, K.L. et al. Prolonged treatment with biologic agents for malignant glioma: A case study with high dose tamoxifen. J Neurooncol 35, 39–45 (1997). https://doi.org/10.1023/A:1005895616377

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  • DOI: https://doi.org/10.1023/A:1005895616377

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