(ChemotherapyAdvisor) – A regimen containing thioguanine, procarbazine, lomustine, and vincristine yields a significantly better survival benefit in patients with low-grade glioma than a regimen containing carboplatin plus vincristine, according to a team of US-based researchers. This conclusion is based on a study entitled “Randomized Study of Two Chemotherapy Regimens for Treatment of Low-Grade Glioma in Young Children: A Report from the Children’s Oncology Group,” which was published in the Journal of Clinical Oncology on July 20.
In this study, the investigators aimed to “compare 2 chemotherapy regimens for low-grade gliomas (LGGs) in children younger than age 10 years for whom radiotherapy was felt by the practitioner to pose a high risk of neurodevelopmental injury.” Enrollees in the study were children younger than 10 years who had previously untreated, progressive or residual LGG. Randomized patients received regimens containing carboplatin plus vincristine (CV; n=137) or thioguanine, procarbazine, lomustine, and vincristine (TPCV; n=137).
The investigators reported the following results for this clinical trial. “The 5-year event-free survival (EFS) and overall survival (OS) rates were 45% ± 3.2% and 86% ± 2.2%, respectively,” they wrote. “The 5-year EFS rates were 39% ± 4% for CV and 52% ± 5% for TPCV (stratified log-rank test P=.10; cure model analysis P=.007).”
The investigators made the following conclusions: “The difference in EFS between the regimens did not reach significance on the basis of the stratified log-rank test, the 5-year EFS was higher for TPCV on the basis of the cure model analysis, and differences in toxicity may influence physician choice of regimens.”