; Thon, Niklas ; Delev, Daniel ; Clusmann, Hans ; Seidel, Clemens ; Güresir, Erdem ; Schmid, Matthias
; Schuss, Patrick
; Giordano, Frank A. ; Radbruch, Alexander ; Becker, Albert ; Weller, Johannes ; Schaub, Christina ; Vatter, Hartmut ; Schilling, Judith ; Winkler, Frank
; Herrlinger, Ulrich ; Schneider, Matthias | Item type: | Article | ||||
|---|---|---|---|---|---|
| Höhe Gebühr (aus OpenAPC): | 1763.72 | ||||
| Institution der Zahlung: | Bonn U | ||||
| Journal or Publication Title: | Trials | ||||
| Publisher: | BMC | ||||
| Place of Publication: | LONDON | ||||
| Volume: | 23 | ||||
| Number of Issue or Book Chapter: | 1 | ||||
| Date: | 2022 | ||||
| Institutions: | Medicine > Lehrstuhl für Neurologie | ||||
| Identification Number: |
| ||||
| Keywords: | COMBINATION; CELLS; LIFE; Glioblastoma; Relapse; Meclofenamate; Temozolomide; Second-line therapy | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 57569 |

Abstract
Background: Glioblastoma is the most frequent and malignant primary brain tumor. Even in the subgroup with O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation and favorable response to first-line therapy, survival after relapse is short (12 months). Standard therapy for recurrent MGMT-methylated glioblastoma is not standardized and may consist of re-resection, re-irradiation, and ...

Abstract
Background: Glioblastoma is the most frequent and malignant primary brain tumor. Even in the subgroup with O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation and favorable response to first-line therapy, survival after relapse is short (12 months). Standard therapy for recurrent MGMT-methylated glioblastoma is not standardized and may consist of re-resection, re-irradiation, and chemotherapy with temozolomide (TMZ), lomustine (CCNU), or a combination thereof. Preclinical results show that meclofenamate (MFA), originally developed as a nonsteroidal anti-inflammatory drug (NSAID) and registered in the USA, sensitizes glioblastoma cells to temozolomide-induced toxicity via inhibition of gap junction-mediated intercellular cytosolic traffic and demolishment of tumor microtube (TM)-based network morphology. Methods: In this study, combined MFA/TMZ therapy will be administered (orally) in patients with first relapse of MGMT-methylated glioblastoma. A phase I component (6-12 patients, 2 dose levels of MFA + standard dose TMZ) evaluates safety and feasibility and determines the dose for the randomized phase II component (2 x 30 patients) with progression-free survival as the primary endpoint. Discussion: This study is set up to assess toxicity and first indications of efficacy of MFA repurposed in the setting of a very difficult-to-treat recurrent tumor. The trial is a logical next step after the identification of the role of resistance-providing TMs in glioblastoma, and results will be crucial for further trials targeting TMs. In case of favorable results, MFA may constitute the first clinically feasible TM-targeted drug and therefore might bridge the idea of a TM-targeted therapeutic approach from basic insights into clinical reality.
Metadata last modified: 29 Feb 2024 12:58
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