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Scherm, Angelika ; Ippen, Franziska Maria ; Hau, Peter ; Baurecht, Hansjörg ; Wick, Wolfgang ; Gempt, Jens ; Knüttel, Helge ; Leitzmann, Michael ; Seliger, Corinna

Targeted therapies in patients with newly diagnosed glioblastoma - a systematic meta-analysis of randomized clinical trials

Scherm, Angelika, Ippen, Franziska Maria , Hau, Peter, Baurecht, Hansjörg , Wick, Wolfgang, Gempt, Jens , Knüttel, Helge , Leitzmann, Michael und Seliger, Corinna (2023) Targeted therapies in patients with newly diagnosed glioblastoma - a systematic meta-analysis of randomized clinical trials. International journal of cancer, (early view).

Veröffentlichungsdatum dieses Volltextes: 06 Feb 2023 07:19
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.53650

Dies ist die aktuelle Version dieses Eintrags.


Zusammenfassung

Glioblastoma (GB) is the most common malignant primary brain tumor in adults. The standard of care for newly diagnosed GB involves surgical resection followed by radiochemotherapy with temozolomide, with or without tumor-treating fields. In recent years, various efforts have been made to identify suitable molecularly targeted treatment options for malignant brain tumors. This meta-analysis ...

Glioblastoma (GB) is the most common malignant primary brain tumor in adults. The standard of care for newly diagnosed GB involves surgical resection followed by radiochemotherapy with temozolomide, with or without tumor-treating fields. In recent years, various efforts have been made to identify suitable molecularly targeted treatment options for malignant brain tumors. This meta-analysis provides an overview of recently published randomized controlled trials (RCTs) with and without molecular stratification, analyzing targeted agents in patients with newly diagnosed GB. The Cochrane Library, MEDLINE (Ovid), ClinicalTrials.gov, WHO's International Clinical Trials Registry Platform, and Google Scholar were searched for RCTs on targeted therapies in patients with newly diagnosed glioblastoma. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were extracted and pooled in a random-effects meta-analysis. Twelve RCTs (n=3,941 patients) involving protein kinase inhibitors, proteasome and histone deacetylase inhibitors, anti-angiogenic approaches, and poly (ADP-ribose) polymerase (PARP) inhibitors were included in the meta-analysis. None of the targeted agents achieved a significant benefit with regard to OS (HR=0.98 [95% Confidence Interval (CI) 0.86-1.11, p=0.7731]. By comparison, targeted therapy showed a benefit for PFS (HR=0.83 [95% CI 0.74-0.94, p=0.0037], especially for patients with an unmethylated O6-Methylguanin-DNA-methyltransferase (MGMT) promoter (0.75 [95% CI 0.56-0.99, p=0.0440]). Prolongation of PFS was largely driven by VEGF inhibition with bevacizumab (HR=0.70 [95% CI 0.61-0.80, p=0.0000]). VEGF inhibition with bevacizumab prolonged PFS in patients with newly diagnosed glioblastoma compared with standard care. However, no improvement in OS was observed with any of the targeted agents.



Beteiligte Einrichtungen


Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftInternational journal of cancer
Verlag:Wiley
Seitenbereich:(early view)
Datum16 Januar 2023
InstitutionenMedizin > Lehrstuhl für Neurologie
Medizin > Institut für Epidemiologie und Präventivmedizin
Zentrale Einrichtungen > Universitätsbibliothek
Identifikationsnummer
WertTyp
36647335PubMed-ID
10.1002/ijc.34433DOI
Stichwörter / Keywordsglioblastoma; meta-analysis; newly diagnosed; randomized trials; targeted agents
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenZum Teil
URN der UB Regensburgurn:nbn:de:bvb:355-epub-536509
Dokumenten-ID53650

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