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Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide

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Veröffentlicht in: Neuro-Oncology 18(2016), 11, Seite 1529-1537
Personen und Körperschaften: Wick, Wolfgang (VerfasserIn), Hartmann, Christian (VerfasserIn), Wick, Antje (VerfasserIn), Platten, Michael (VerfasserIn), Deimling, Andreas von (VerfasserIn), Wiestler, Benedikt (VerfasserIn)
Titel: Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide/ Wolfgang Wick, Patrick Roth, Christian Hartmann, Peter Hau, Makoto Nakamura, Florian Stockhammer, Michael C. Sabel, Antje Wick, Susanne Koeppen, Ralf Ketter, Peter Vajkoczy, Ilker Eyupoglu, Rolf Kalff, Torsten Pietsch, Caroline Happold, Norbert Galldiks, Friederike Schmidt-Graf, Michael Bamberg, Guido Reifenberger, Michael Platten, Andreas von Deimling, Christoph Meisner, Benedikt Wiestler, and Michael Weller for the Neurooncology Working Group (NOA) of the German Cancer Society
Format: E-Book-Kapitel
Sprache: Englisch
veröffentlicht:
1 July 2016
Gesamtaufnahme: : Neuro-Oncology, 18(2016), 11, Seite 1529-1537
, volume:18
Quelle: Verbunddaten SWB
Lizenzfreie Online-Ressourcen
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author Wick, Wolfgang, Hartmann, Christian, Wick, Antje, Platten, Michael, Deimling, Andreas von, Wiestler, Benedikt
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contents Background: Optimal treatment and precise classification for anaplastic glioma are needed. Methods: The objective for long-term follow-up of NOA-04 is to optimize the treatment sequence for patients with anaplastic gliomas. Patients were randomized 2:1:1 to receive the standard radiotherapy (RT) (arm A), procarbazine, lomustine and vincristine (PCV) (arm B1), or temozolomide (TMZ) (arm B2). Results: Primary endpoint was time-to-treatment-failure (TTF), defined as progression after 2 lines of therapy or any time before if no further therapy was administered. Exploratory analyses examined associations of molecular marker status with TTF, progression-free survival (PFS), and overall survival (OS). At 9.5 (95% CI: 8.6-10.2) years, no difference between arms (A vs B1/B2) was observed: median TTF (4.6 [3.4-5.1] y vs 4.4 [3.3-5.3) y), PFS (2.5 [1.3-3.5] y vs 2.7 [1.9-3.2] y), and OS (8 [5.5-10.3] y vs 6.5 [5.4-8.3] y). Oligodendroglial versus astrocytic histology—but more so the subgroups according to CpG island methylator phenotype (CIMP) and 1p/19q co-deletion status—revealed a strong prognostic value of CIMPpos with (CIMPcodel) versus without 1p/19 co-deletion (CIMPnon-codel) versus CIMPneg. but no differential efficacy of RT versus chemotherapy for any of the endpoints. PFS was better for PCV- than for TMZ-treated patients with CIMPcodel tumors (HR B1 vs B2 0.39 [0.17-0.92], P = .031). In CIMPneg. tumors, hypermethylation of the O6-methyl-guanyl-DNA methyltransferase promoter (MGMT) provided a risk reduction for PFS with chemotherapy. Conclusions: There is no differential activity of primary chemotherapy versus RT in any subgroup of anaplastic glioma. Molecular diagnosis is superior to histology., Trial Registration: clinicaltrials.gov Identifier: NCT00717210.
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spelling Wick, Wolfgang 1970- VerfasserIn (DE-588)120297736 (DE-627)080586929 (DE-576)186221320 aut, Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide Wolfgang Wick, Patrick Roth, Christian Hartmann, Peter Hau, Makoto Nakamura, Florian Stockhammer, Michael C. Sabel, Antje Wick, Susanne Koeppen, Ralf Ketter, Peter Vajkoczy, Ilker Eyupoglu, Rolf Kalff, Torsten Pietsch, Caroline Happold, Norbert Galldiks, Friederike Schmidt-Graf, Michael Bamberg, Guido Reifenberger, Michael Platten, Andreas von Deimling, Christoph Meisner, Benedikt Wiestler, and Michael Weller for the Neurooncology Working Group (NOA) of the German Cancer Society, 1 July 2016, 9, Text txt rdacontent, Computermedien c rdamedia, Online-Ressource cr rdacarrier, Gesehen am 27.11.2017, Background: Optimal treatment and precise classification for anaplastic glioma are needed. Methods: The objective for long-term follow-up of NOA-04 is to optimize the treatment sequence for patients with anaplastic gliomas. Patients were randomized 2:1:1 to receive the standard radiotherapy (RT) (arm A), procarbazine, lomustine and vincristine (PCV) (arm B1), or temozolomide (TMZ) (arm B2). Results: Primary endpoint was time-to-treatment-failure (TTF), defined as progression after 2 lines of therapy or any time before if no further therapy was administered. Exploratory analyses examined associations of molecular marker status with TTF, progression-free survival (PFS), and overall survival (OS). At 9.5 (95% CI: 8.6-10.2) years, no difference between arms (A vs B1/B2) was observed: median TTF (4.6 [3.4-5.1] y vs 4.4 [3.3-5.3) y), PFS (2.5 [1.3-3.5] y vs 2.7 [1.9-3.2] y), and OS (8 [5.5-10.3] y vs 6.5 [5.4-8.3] y). Oligodendroglial versus astrocytic histology—but more so the subgroups according to CpG island methylator phenotype (CIMP) and 1p/19q co-deletion status—revealed a strong prognostic value of CIMPpos with (CIMPcodel) versus without 1p/19 co-deletion (CIMPnon-codel) versus CIMPneg. but no differential efficacy of RT versus chemotherapy for any of the endpoints. PFS was better for PCV- than for TMZ-treated patients with CIMPcodel tumors (HR B1 vs B2 0.39 [0.17-0.92], P = .031). In CIMPneg. tumors, hypermethylation of the O6-methyl-guanyl-DNA methyltransferase promoter (MGMT) provided a risk reduction for PFS with chemotherapy. Conclusions: There is no differential activity of primary chemotherapy versus RT in any subgroup of anaplastic glioma. Molecular diagnosis is superior to histology., Trial Registration: clinicaltrials.gov Identifier: NCT00717210., Hartmann, Christian VerfasserIn (DE-588)1030180539 (DE-627)734895240 (DE-576)377991465 aut, Wick, Antje 1972- VerfasserIn (DE-588)122759869 (DE-627)706032101 (DE-576)293409609 aut, Platten, Michael 1971- VerfasserIn (DE-588)121627780 (DE-627)081431848 (DE-576)261969811 aut, Deimling, Andreas von 1959- VerfasserIn (DE-588)103034115X (DE-627)735093946 (DE-576)378138065 aut, Wiestler, Benedikt 1983- VerfasserIn (DE-588)1014415837 (DE-627)705225879 (DE-576)348205139 aut, Enthalten in Neuro-Oncology Oxford : Oxford Univ. Press, 1999 18(2016), 11, Seite 1529-1537 Online-Ressource (DE-627)357167341 (DE-600)2094060-9 (DE-576)318041839 1523-5866 nnns, volume:18 year:2016 number:11 pages:1529-1537 extent:9, http://dx.doi.org/10.1093/neuonc/now133 Verlag Resolving-System kostenfrei Volltext, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5063521/ Verlag kostenfrei Volltext, http://dx.doi.org/10.1093/neuonc/now133 LFER, LFER 2017-12-07T00:00:00Z
spellingShingle Wick, Wolfgang, Hartmann, Christian, Wick, Antje, Platten, Michael, Deimling, Andreas von, Wiestler, Benedikt, Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide, Background: Optimal treatment and precise classification for anaplastic glioma are needed. Methods: The objective for long-term follow-up of NOA-04 is to optimize the treatment sequence for patients with anaplastic gliomas. Patients were randomized 2:1:1 to receive the standard radiotherapy (RT) (arm A), procarbazine, lomustine and vincristine (PCV) (arm B1), or temozolomide (TMZ) (arm B2). Results: Primary endpoint was time-to-treatment-failure (TTF), defined as progression after 2 lines of therapy or any time before if no further therapy was administered. Exploratory analyses examined associations of molecular marker status with TTF, progression-free survival (PFS), and overall survival (OS). At 9.5 (95% CI: 8.6-10.2) years, no difference between arms (A vs B1/B2) was observed: median TTF (4.6 [3.4-5.1] y vs 4.4 [3.3-5.3) y), PFS (2.5 [1.3-3.5] y vs 2.7 [1.9-3.2] y), and OS (8 [5.5-10.3] y vs 6.5 [5.4-8.3] y). Oligodendroglial versus astrocytic histology—but more so the subgroups according to CpG island methylator phenotype (CIMP) and 1p/19q co-deletion status—revealed a strong prognostic value of CIMPpos with (CIMPcodel) versus without 1p/19 co-deletion (CIMPnon-codel) versus CIMPneg. but no differential efficacy of RT versus chemotherapy for any of the endpoints. PFS was better for PCV- than for TMZ-treated patients with CIMPcodel tumors (HR B1 vs B2 0.39 [0.17-0.92], P = .031). In CIMPneg. tumors, hypermethylation of the O6-methyl-guanyl-DNA methyltransferase promoter (MGMT) provided a risk reduction for PFS with chemotherapy. Conclusions: There is no differential activity of primary chemotherapy versus RT in any subgroup of anaplastic glioma. Molecular diagnosis is superior to histology., Trial Registration: clinicaltrials.gov Identifier: NCT00717210.
swb_id_str 495742201
title Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide
title_auth Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide
title_full Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide Wolfgang Wick, Patrick Roth, Christian Hartmann, Peter Hau, Makoto Nakamura, Florian Stockhammer, Michael C. Sabel, Antje Wick, Susanne Koeppen, Ralf Ketter, Peter Vajkoczy, Ilker Eyupoglu, Rolf Kalff, Torsten Pietsch, Caroline Happold, Norbert Galldiks, Friederike Schmidt-Graf, Michael Bamberg, Guido Reifenberger, Michael Platten, Andreas von Deimling, Christoph Meisner, Benedikt Wiestler, and Michael Weller for the Neurooncology Working Group (NOA) of the German Cancer Society
title_fullStr Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide Wolfgang Wick, Patrick Roth, Christian Hartmann, Peter Hau, Makoto Nakamura, Florian Stockhammer, Michael C. Sabel, Antje Wick, Susanne Koeppen, Ralf Ketter, Peter Vajkoczy, Ilker Eyupoglu, Rolf Kalff, Torsten Pietsch, Caroline Happold, Norbert Galldiks, Friederike Schmidt-Graf, Michael Bamberg, Guido Reifenberger, Michael Platten, Andreas von Deimling, Christoph Meisner, Benedikt Wiestler, and Michael Weller for the Neurooncology Working Group (NOA) of the German Cancer Society
title_full_unstemmed Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide Wolfgang Wick, Patrick Roth, Christian Hartmann, Peter Hau, Makoto Nakamura, Florian Stockhammer, Michael C. Sabel, Antje Wick, Susanne Koeppen, Ralf Ketter, Peter Vajkoczy, Ilker Eyupoglu, Rolf Kalff, Torsten Pietsch, Caroline Happold, Norbert Galldiks, Friederike Schmidt-Graf, Michael Bamberg, Guido Reifenberger, Michael Platten, Andreas von Deimling, Christoph Meisner, Benedikt Wiestler, and Michael Weller for the Neurooncology Working Group (NOA) of the German Cancer Society
title_in_hierarchy Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide / Wolfgang Wick, Patrick Roth, Christian Hartmann, Peter Hau, Makoto Nakamura, Florian Stockhammer, Michael C. Sabel, Antje Wick, Susanne Koeppen, Ralf Ketter, Peter Vajkoczy, Ilker Eyupoglu, Rolf Kalff, Torsten Pietsch, Caroline Happold, Norbert Galldiks, Friederike Schmidt-Graf, Michael Bamberg, Guido Reifenberger, Michael Platten, Andreas von Deimling, Christoph Meisner, Benedikt Wiestler, and Michael Weller for the Neurooncology Working Group (NOA) of the German Cancer Society,
title_short Long-term analysis of the NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with PCV or temozolomide
title_sort long term analysis of the noa 04 randomized phase iii trial of sequential radiochemotherapy of anaplastic glioma with pcv or temozolomide
url http://dx.doi.org/10.1093/neuonc/now133, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5063521/