A multicenter phase I/II study of the BCNU implant (Gliadel((R)) Wafer) for Japanese patients with malignant gliomas

  • AOKI Tomokazu
    Department of Neurosurgery, National Hospital Organization Kyoto Medical Center
  • NISHIKAWA Ryo
    Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center
  • SUGIYAMA Kazuhiko
    Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University
  • NONOGUCHI Naosuke
    Department of Neurosurgery, Kitano Hospital
  • KAWABATA Noriyuki
    Department of Neurosurgery, Kitano Hospital
  • MISHIMA Kazuhiko
    Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center
  • ADACHI Jun-ichi
    Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center
  • KURISU Kaoru
    Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University
  • YAMASAKI Fumiyuki
    Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University
  • TOMINAGA Teiji
    Department of Neurosurgery, Tohoku University Graduate School of Medicine
  • KUMABE Toshihiro
    Department of Neurosurgery, Tohoku University Graduate School of Medicine Department of Neurosurgery, Kitasato University School of Medicine (current affiliation)
  • UEKI Keisuke
    Department of Neurosurgery, Dokkyo Medical University Hospital
  • HIGUCHI Fumi
    Department of Neurosurgery, Dokkyo Medical University Hospital
  • YAMAMOTO Tetsuya
    Department of Neurosurgery, Faculty of Medicine, University of Tsukuba
  • ISHIKAWA Eiichi
    Department of Neurosurgery, Faculty of Medicine, University of Tsukuba
  • TAKESHIMA Hideo
    Department of Neurosurgery, Faculty of Medicine, University of Miyazaki Hospital
  • YAMASHITA Shinji
    Department of Neurosurgery, Faculty of Medicine, University of Miyazaki Hospital
  • ARITA Kazunori
    Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University
  • HIRANO Hirofumi
    Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University
  • YAMADA Shinobu
    Nobelpharma Co., Ltd.
  • MATSUTANI Masao
    Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center

書誌事項

タイトル別名
  • A Multicenter Phase I/II Study of the BCNU Implant (Gliadel<sup>®</sup> Wafer) for Japanese Patients with Malignant Gliomas
  • A multicenter phase I/II study of the BCNU implant (Gliadel® Wafer) for Japanese patients with malignant gliomas
  • A multicenter phase I/II study of BCNU implant for Japanese patients with malignant gliomas

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抄録

Carmustine (BCNU) implants (Gliadel® Wafer, Eisai Inc., New Jersey, USA) for the treatment of malignant gliomas (MGs) were shown to enhance overall survival in comparison to placebo in controlled clinical trials in the United States and Europe. A prospective, multicenter phase I/II study involving Japanese patients with MGs was performed to evaluate the efficacy, safety, and pharmacokinetics of BCNU implants. The study enrolled 16 patients with newly diagnosed MGs and 8 patients with recurrent MGs. After the insertion of BCNU implants (8 sheets maximum, 61.6 mg BCNU) into the removal cavity, various chemotherapies (including temozolomide) and radiotherapies were applied. After placement, overall and progression-free survival rates and whole blood BCNU levels were evaluated. In patients with newly diagnosed MGs, the overall survival rates at 12 months and 24 months were 100.0% and 68.8%, and the progression-free survival rate at 12 months was 62.5%. In patients with recurrent MGs, the progression-free survival rate at 6 months was 37.5%. There were no grade 4 or higher adverse events noted due to BCNU implants, and grade 3 events were observed in 5 of 24 patients (20.8%). Whole blood BCNU levels reached a peak of 19.4 ng/mL approximately 3 hours after insertion, which was lower than 1/600 of the peak BCNU level recorded after intravenous injections. These levels decreased to less than the detection limit (2.00 ng/mL) after 24 hours. The results of this study involving Japanese patients are comparable to those of previous studies in the United States and Europe.

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