TY - JOUR AB - The therapeutic management of recurrent malignant gliomas (MGs) is not determined. Therefore, the efficacy of a multimodal approach and a combination systemic therapy was investigated. A retrospective analysis of 26 MGs patients at first relapse treated with multimodal therapy (chemotherapy plus surgery and/or reirradiation) or chemotherapy alone was performed. Second-line chemotherapy consisted of fotemustine (FTM) in combination with bevacizumab (BEV) (cFTM/BEV) or followed by third-line BEV (sFTM/BEV). Subgroup analyses were performed. Multimodal therapy provided a higher overall response rate (ORR) (73 vs. 47%), disease control rate (DCR) (82 vs. 67%), median progression-free survival (mPFS) (11 vs. 7 months; P=0.08) and median overall survival (mOS) (13 vs. 8 months; P=0.04) compared with chemotherapy. Concomitant FTM/BEV resulted in higher ORR (84 vs. 36%), DCR (92 vs. 57%), mPFS (10 vs. 5 months; P=0.22) and mOS (11 vs. 5.2 months; P=0.15) compared with sFTM/BEV. Methylated patients did not experience additional survival benefits with multimodality treatment but had higher mPFS (10 vs 7.1 months; P=0.33) and mOS (11 vs. 8 months; P=0.33) with cFTM/BEV. Unmethylated patients experienced the greatest survival benefit with the multimodal approach (mPFS: 10 vs. 5 months; mOS 11 vs 6 months; both P=0.02) and cFTM/BEV (mPFS: 5 vs. 2 months; mOS 6 vs. 3.2 months; both P=0.01). In conclusion, in recurrent MGs, multimodal therapy and cFTM/BEV provide survival and response benefits. Methylated patients benefit from a cFTM/BEV but not from a multimodal approach. Notably, unmethylated patients had the highest survival benefit with the two strategies. AD - Department of Medical Oncology Unit A, Policlinico Umberto I, ‘Sapienza’ University of Rome, Ι-00161 Rome, Italy Department of Medical Oncology, Ospedale Policlinico San Martino IST, Ι-16132 Genoa, Italy Department of Radiological, Oncological and Anatomo-Pathological Sciences, ‘Sapienza’ University of Rome, Policlinico Umberto I, I-00161 Rome, Italy Department of Public Health and Infectious Diseases, ‘Sapienza’ University of Rome, Ι-00185 Rome, Italy Department of Neurosurgery, IRCCS Neuromed, Ι-86077 Pozzilli, Italy Department of Medico-Surgical Sciences and Biotechnologies, ‘Sapienza’ University of Rome, Ι-00185 Rome, Italy AU - Prelaj,Arsela AU - Rebuzzi,Sara ,Elena AU - Grassi,Massimiliano AU - Giròn Berrìos,Julio ,Rodrigo AU - Pecorari,Silvia AU - Fusto,Carmela AU - Ferrara,Carla AU - Salvati,Maurizio AU - Stati,Valeria AU - Tomao,Silverio AU - Bianco,Vincenzo DA - 2019/01/01 DO - 10.3892/mco.2018.1745 EP - 57 IS - 1 JO - Mol Clin Oncol KW - recurrent malignant gliomas recurrent glioblastomas multimodal surgery radiotherapy chemotherapy fotemustine bevacizumab PY - 2019 SN - 2049-9450 2049-9469 SP - 49 ST - Multimodal treatment for local recurrent malignant gliomas: Resurgery and/or reirradiation followed by chemotherapy T2 - Molecular and Clinical Oncology TI - Multimodal treatment for local recurrent malignant gliomas: Resurgery and/or reirradiation followed by chemotherapy UR - https://doi.org/10.3892/mco.2018.1745 VL - 10 ER -