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. 2023 Aug 15;13(8):3668-3678.
eCollection 2023.

Brief report: pediatric high-grade gliomas treated with vinorelbine and valproic acid added to temozolomide

Milena Guidi  1 , Laura Giunti  1 , Anna Maria Buccoliero  2 , Carla Fonte  1 , Silvia Scoccianti  3 , Maria Luigia Censullo  1 , Chiara Caporalini  2 , Marco Tellini  1 , Marco Di Nicola  1 , Barbara Castelli  1 , Daniela Greto  3 , Flavio Giordano  4 , Lorenzo Genitori  4 , Iacopo Sardi  1
Affiliations

Brief report: pediatric high-grade gliomas treated with vinorelbine and valproic acid added to temozolomide

Milena Guidi et al. Am J Cancer Res. .

Abstract

Children and young adult with high grade gliomas (HGG) have dismal prognoses and treatment options remain limited. We present 19 patients diagnosed with anaplastic astrocytoma (AA) or glioblastoma (GBM) treated with concomitant and adjuvant 20-30 mg/m2/dose of vinorelbine and 30 mg/kg/day valproic acid (VA) in combination to consolidated TMZ and focal RT after maximal surgery. We evaluated the feasibility of treating children diagnosed with HGG. The median follow-up time was 51.4 months (range, 6.2-106.6 months). The 5-year OS was 57.9% (CI 95%, 33.2-76.3) and the 5-year PFS was 57.9% (CI 95%, 33.2-76.3). Eight patients (42.1%) have progressed so far, with a median time to progression of 9 months from diagnosis (range, 4.6-34.7 months). All of them died for disease progression. At time of analysis, 11 patients were still alive with no evidence of disease. It is notable that all events occurred within 35 months from the start of therapy. All 19 treated patients reported low-grade drug-related adverse events (AEs). The treatment was well tolerated in our limited cohort of patients without significant toxicity. Further studies of the efficacy and safety of combination of vinorelbine/VA to consolidated RT/TMZ therapy in children with HGG are underway in a clinical trial setting.

Keywords: High-grade gliomas; anaplastic astrocytoma; glioblastoma; radiotherapy; temozolomide; valproic acid; vinorelbine.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Treatment schedule.
Figure 2
Figure 2
Overall survival (A) and Progression-free survival (B) and of the series.
Figure 3
Figure 3
Overall survival (A) and Progression-free survival (B) and of the series according to histology (glioblastoma vs anaplastic astrocytoma).
See this image and copyright information in PMC

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