P14.14.A INTRA-ARTERIAL CHEMOTHERAPY TREATMENT FOR RELAPSING GLIOBLASTOMA: RESULTS FROM A FIVE-YEAR SERIES
Bibliographic record
Abstract
Abstract BACKGROUND Glioblastoma (GBM) is the most common and aggressive type of primary brain tumour in adults. The GBM malignant phenotype depicts anarchic invasion of the brain parenchyma as well as radio-/chemoresistant properties. The complete surgical resection is unachievable and responses to standard therapy are invariably transient. In addition to the malignant GBM phenotype, the blood-brain barrier (BBB) is one of the prominent features that limits the efficacy of chemotherapy. Indeed, this facet of the brain’s blood vessels significantly blocks the passage of numerous therapeutic molecules from the blood stream to the brain. Tumour progression often occurs during or after standard first-line therapy which includes radiotherapy with concomitant and adjuvant temozolomide. The median overall survival (OS) is 14.6 months, but recurrence occurs on average only seven months after the initial diagnosis. At relapse, there is no consensus on the standard of care and the median OS ranges between three and nine months. At our institution, we use intra-arterial infusion to treat relapsing GBMs. This delivery strategy bypasses the first pass and significantly increases the local peak plasma concentration and area under the curve. This leads to a 3 to 5 fold increase of the chemotherapy concentration in the glioma-infiltrated brain parenchyma. Over the last 15 years, we have treated more than 722 patients for a total of 3600 intra-arterial chemotherapy (IAC) procedures. MATERIAL AND METHODS In this revision of the 2018-2023 series, we treated 59 relapsing GBM patients. Every IAC procedure was completed every four to six weeks. We reviewed the medical files to follow treatment evolution, tumour response and for grades 3 and 4 toxicity. RESULTS During this five-year period, a total of 406 arteriographic procedures were completed. The following chemotherapeutic agents were used: carboplatin, melphalan, methotrexate, Caelyx, carboplatin + melphalan, carboplatin + methotrexate, carboplatin + etoposide phosphate or melphalan + methotrexate. The median OS from diagnosis and relapse were 24 and 9 months respectively. A total of 28 patients suffered one or more grade 3 hematological toxicity events (17% of IAC cycles). Likewise, 24 grade 4 hematological toxicity events occurred in 16 patients (6% of IAC procedure). CONCLUSION In comparison with published clinical trials results, the data from our series suggest that IAC is a promising strategy for the treatment of relapsing GBM. We will gather more data and perform uni- and multivariate analyses. Moreover, we will soon begin a randomized clinical trial to test the combination of carboplatin + etoposide phosphate and carboplatin + Caelyx in the treatment of relapsing GBM. Furthermore, we are currently conducting preclinical experiment using topotecan, cytarabin and paclitaxel to determine their effectiveness in the IAC setting.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".