A Randomized Phase II Study of Everolimus in Combination With Chemoradiation in Newly Diagnosed Glioblastoma: Results of NRG Oncology RTOG 0913
Department
neurology
Document Type
Article
Abstract
Background This phase II study was designed to determine the efficacy of the mammalian target of rapamycin (mTOR) inhibitor everolimus administered daily with conventional radiation therapy and chemotherapy in patients with newly diagnosed glioblastoma. Methods Patients were randomized to radiation therapy with concurrent and adjuvant temozolomide with or without daily everolimus (10 mg). The primary endpoint was progression-free survival (PFS) and the secondary endpoints were overall survival (OS) and treatment-related toxicities. Results A total of 171 patients were randomized and deemed eligible for this study. Patients randomized to receive everolimus experienced a significant increase in both grade 4 toxicities, including lymphopenia and thrombocytopenia, and treatment-related deaths. There was no significant difference in PFS between patients randomized to everolimus compared with control (median PFS time: 8.2 vs 10.2 mo, respectively; P = 0.79). OS for patients randomized to receive everolimus was inferior to that for control patients (median survival time: 16.5 vs 21.2 mo, respectively; P = 0.008). A similar trend was observed in both O 6-methylguanine-DNA-methyltransferase promoter hypermethylated and unmethylated tumors. Conclusion Combining everolimus with conventional chemoradiation leads to increased treatment-related toxicities and does not improve PFS in patients with newly diagnosed glioblastoma. Although the median survival time in patients receiving everolimus was comparable to contemporary studies, it was inferior to the control in this randomized study.
Medical Subject Headings
neurology
Publication Date
2018
Publication Title
Neuro-Oncology
ISSN
1522-8517
Volume
20
Issue
5
First Page
666
Last Page
673
Digital Object Identifier (DOI)
10.1093/neuonc/nox209
Recommended Citation
Chinnaiyan, Prakash; Won, Minhee; Wen, Patrick Y.; Rojiani, Amyn M.; Werner-Wasik, Maria; Shih, Helen A.; Ashby, Lynn S.; Yu, Hsiang Hsuan Michael; Stieber, Volker W.; Malone, Shawn C.; Fiveash, John B.; Mohile, Nimish A.; Ahluwalia, Manmeet S.; Wendland, Merideth M.; Stella, Philip J.; Kee, Andrew Y.; and Mehta, Minesh P., "A Randomized Phase II Study of Everolimus in Combination With Chemoradiation in Newly Diagnosed Glioblastoma: Results of NRG Oncology RTOG 0913" (2018). Neurology. 1.
https://scholar.barrowneuro.org/neurology/1