Effects of lomustine: A Synthesis of Findings from 25 Studies

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Original Abstract of the Article

Major Research Findings

Lomustine is an alkylating agent used in the treatment of progressive gliomas. 9 A study investigated whether the combination of lomustine and bevacizumab could extend the survival of patients with progressive glioblastoma, the results suggesting that this combination could be beneficial for survival. 19 A study found that radiotherapy combined with temozolomide may extend survival in high-risk, low-grade gliomas after surgery. 1 A study compared the effectiveness and safety of three chemotherapy regimens, including lomustine, in patients with malignant lymphomas. 21 A study examined the effects of lomustine and its metabolites on DNA alkylation and carbamylation, as well as the expression of MGMT in canine cells. 14 A study discovered that electromagnetic pulse (EMP) could potentially enhance the delivery of lomustine to gliomas and increase treatment efficacy. 10 A study analyzed the complications of high-grade glioma surgery with concurrent chemotherapy. 23 A study evaluated the effectiveness of lomustine in treating presumptive haemophagocytic histiocytic sarcoma in Flat-coated Retrievers. 4 A study compared the efficacy and safety of regorafenib and lomustine in patients with recurrent glioblastoma. 11 A review summarized the latest advancements in molecular diagnosis, management, and future directions for IDH-mutant low-grade gliomas. 6 A study explored the inhibition of KDM2B as a target for glioma stem-like cell survival and chemoresistance. 15 A study investigated the potential of HDL-mimicking nanodiscs for chemo-immunotherapy against glioblastoma multiforme. 8 A study indicated that increased infiltration of CD8 T cells in recurrent glioblastoma patients could be a valuable biomarker for assessing response to combined bevacizumab and lomustine therapy. 18 A study examined the risk factors for short adult height in childhood cancer survivors. 5 A study documented the occurrence of pseudoprogression in patients with anaplastic oligodendrogliomas treated with procarbazine, lomustine, and vincristine (PCV) chemotherapy alone. 24 A case report highlighted prolonged survival after treatment of histiocytic sarcoma of the canine urinary bladder with lomustine. 16 A study investigated the tolerability of procarbazine, lomustine, and vincristine (PCV) chemotherapy for one year in patients with low-grade glioma. 12 A study discussed DNA repair in personalized brain cancer therapy with temozolomide and nitrosoureas. 25 A report described a fatal case of lomustine overdose in a dog. 13 A study compared the value of MRI and FET PET for response evaluation in glioblastoma patients treated with bevacizumab plus lomustine at first progression. 22 A network meta-analysis reviewed treatment options for progression or recurrence of glioblastoma. 3 A secondary analysis of EORTC 26101 explored the incidence and consequences of thrombocytopenia induced by lomustine in recurrent glioblastoma. 17 A study found that carnosic acid inhibits cell growth and enhances the anticancer effects of carmustine and lomustine in melanoma. 7 A study investigated the long-term impact of radiochemotherapy followed by maintenance chemotherapy with cisplatin, lomustine, and vincristine on neurocognitive functioning and health-related quality of life in adult medulloblastoma patients. 20 A multicenter pilot study evaluated the feasibility and toxicity of radio-polychemotherapy as a first-line treatment for adults with medulloblastoma. 2 A study demonstrated that inhibiting intercellular cytosolic traffic via gap junctions enhances lomustine-induced toxicity in glioblastoma, independent of MGMT promoter methylation status.

Benefits and Risks

Benefits Summary

Lomustine may be an effective treatment for progressive gliomas, potentially extending survival and improving response to other therapies. 9 、 19 、 17 、 14 、 6 、 15 、 8 。

Risks Summary

Lomustine can cause various side effects, including nausea, vomiting, loss of appetite, fatigue, fever, low platelet count, low white blood cell count, bone marrow suppression, hair loss, and liver problems. 25 、 23 、 3 。 It is important to discuss these potential risks with your doctor before starting lomustine treatment.

Comparison Between Studies

Commonalities

All studies acknowledge that lomustine is an alkylating agent used to treat gliomas and potentially has positive effects in treating gliomas. 9 、 19 、 1 、 21 、 14 、 10 、 23 、、 11 、 6 、 15 、 8 、 18 、 5 、 24 、 16 、 12 、 25 、 13 、 22 、 3 、 17 、 7 、 20 、 2 。 The research also indicates that lomustine can have side effects. 25 、 3 。

Differences

Each study investigates different aspects of lomustine. For example, some studies explore its use in combination with other drugs, such as bevacizumab or temozolomide, while others focus on specific types of gliomas or examine its effects in different settings, like surgery or transplantation. 9 、 19 、 1 、 14 、 10 、 4 、 6 、 15 、 8 、 2 。 Some studies delve into the mechanisms of action, such as DNA alkylation or the role of MGMT, while others investigate the effectiveness of lomustine in various patient populations or animal models. 21 、 23 、 7 、 12 、 25 、 13 、 22 、 3 、 20 。

Consistency and Contradictions in Results

The research consistently suggests that lomustine can be an effective treatment option for progressive gliomas, potentially extending survival. 9 、 19 、 22 、 2 。 However, it is crucial to recognize that lomustine is not universally effective and can cause side effects. 25 、 3 。 The effectiveness and side effects of lomustine can vary depending on factors such as the patient's age, health condition, and other medications they are taking.

Practical Considerations

It is vital to remember that lomustine should be used only under the guidance of a healthcare professional. 9 、 19 、、 20 。 Consult with your doctor before starting lomustine treatment, and report any adverse health changes during treatment. Lomustine may be an effective option for treating progressive gliomas, but it can also cause side effects.

Limitations of Current Research

These studies have limitations, such as small sample sizes and specific patient populations, which may limit the generalizability of findings. 9 、 19 、、 20 。 Moreover, the studies may not have adequately addressed the long-term effects of lomustine.

Future Research Directions

Larger studies with broader patient populations are needed to further confirm the effectiveness and safety of lomustine. 9 、 19 、、 20 。 Research should compare the efficacy of lomustine with other treatment options and examine its long-term effects. Evaluating the effectiveness and safety of lomustine across various patient groups is also critical.

Conclusion

Lomustine shows promise as a potential treatment for progressive gliomas, with evidence suggesting it can extend survival and enhance the effectiveness of other therapies. 9 、 19 、 17 、 14 、 6 、 15 、 8 。 However, remember that lomustine can have side effects, so it is essential to consult with your doctor to make an informed decision about its use. Further research is necessary to confirm its benefits and risks, compare it with other treatment options, and investigate its long-term effects.

Literature analysis of 25 papers
Positive Content
18
Neutral Content
4
Negative Content
3
Article Type
3
1
1
3
24
2.

Inhibition of Intercellular Cytosolic Traffic via Gap Junctions Reinforces Lomustine-Induced Toxicity in Glioblastoma Independent of MGMT Promoter Methylation Status.

Author: SchneiderMatthias, PotthoffAnna-Laura, EvertBernd O, DicksMarius, EhrentrautDenise, DolfAndreas, SchmidtElena N C, SchäferNiklas, BorgerValeri, PietschTorsten, WesthoffMike-Andrew, GüresirErdem, WahaAndreas, VatterHartmut, HeilandDieter H, SchussPatrick, HerrlingerUlrich

Glioblastoma treatment

This study investigated the antitumoral effects of lomustine, a chemotherapeutic agent, in glioblastoma patients, regardless of MGMT promoter methylation status. Pharmacological inhibition of intercellular cytosolic traffic via gap junctions enhanced the antitumoral effects of lomustine, suggesting a potential therapeutic strategy for all glioblastoma patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

3.

Thrombocytopenia limits the feasibility of salvage lomustine chemotherapy in recurrent glioblastoma: a secondary analysis of EORTC 26101.

Author: Le RhunEmilie, OppongFelix Boakye, van den BentMartin, WickWolfgang, BrandesAlba A, TaphoornMartin Jb, PlattenMichael, IdbaihAhmed, ClementPaul M, PreusserMatthias, GolfinopoulosVassilis, GorliaThierry, WellerMichael

Improved outcome
Thrombocytopenia

Thrombocytopenia was the leading cause of dose modification for lomustine chemotherapy in recurrent glioblastoma. Dose modification due to thrombocytopenia was associated with inferior progression-free survival and overall survival in patients with MGMT promoter-methylated tumors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

Regorafenib compared with lomustine in patients with relapsed glioblastoma (REGOMA): a multicentre, open-label, randomised, controlled, phase 2 trial.

Author: LombardiGiuseppe, De SalvoGian Luca, BrandesAlba Ariela, EoliMarica, RudàRoberta, FaediMarina, LolliIvan, PaceAndrea, DanieleBruno, PasqualettiFrancesco, RizzatoSimona, BelluLuisa, PambukuArdi, FarinaMiriam, MagniGiovanna, IndraccoloStefano, GardimanMarina Paola, SoffiettiRiccardo, ZagonelVittorina

Glioblastoma treatment
None mentioned

This study assessed the efficacy and safety of regorafenib in the treatment of recurrent glioblastoma.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

T2-Fluid-attenuated inversion recovery (FLAIR) pseudoprogression in patients with anaplastic oligodendrogliomas treated with procarbazine, lomustine and vincristine (PCV) chemotherapy alone.

Author: Esparragosa VazquezInés, NdiayeMané, Di StefanoAnna Luisa, YounanNadia, Larrieu-CironDelphine, SeyveAntoine, PicartThiébaud, MeyronetDavid, BoutetClaire, VassalFrançois, CarpentierCatherine, Figarella-BrangerDominique, DehaisCaroline, ForestFabien, RivoirardRomain, DucrayFrançois,

Chemotherapy alone
Pseudoprogression

Pseudoprogression is a phenomenon that can occur after treatment for glioma. This article describes the occurrence of pseudoprogression in patients with anaplastic oligodendrogliomas who were treated with chemotherapy alone.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Targeting glioma stem-like cell survival and chemoresistance through inhibition of lysine-specific histone demethylase KDM2B.

Author: StabergMikkel, RasmussenRikke Darling, MichaelsenSigne Regner, PedersenHenriette, JensenKamilla Ellermann, VillingshøjMette, Skjoth-RasmussenJane, BrennumJannick, Vitting-SeerupKristoffer, PoulsenHans Skovgaard, HamerlikPetra

GBM treatment

KDM2B, a chromatin regulator, was found to be highly expressed in glioblastoma surgical specimens. Targeting KDM2B function impaired the survival of glioblastoma cells and sensitized them to chemotherapy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Neurocognitive functioning and health-related quality of life in adult medulloblastoma patients: long-term outcomes of the NOA-07 study.

Author: DirvenLinda, LuerdingRalf, BeierDagmar, BumesElisabeth, ReinertChristiane, SeidelClemens, BonsantoMatteo Mario, BremerMichael, RiekenStefan, CombsStephanie E, HerrlingerUlrich, SeligerCorinna, KuntzeHolger, Mayer-SteinackerRegine, DieingAnnette, BartelsClaudius, SchnellOliver, WeyerbrockAstrid, SeidelSabine, GrauerOliver, Nadji-OhlMinou, PaulsenFrank, WellerMichael, WickWolfgang, HauPeter

Neurocognitive impairment

Combined radiochemotherapy followed by maintenance chemotherapy resulted in long-term neurocognitive impairments and reduced health-related quality of life in adult medulloblastoma patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Increased infiltration of CD8 T cells in recurrent glioblastoma patients is a useful biomarker for assessing the response to combined bevacizumab and lomustine therapy.

Author: LinPeng, JiangHao, ZhaoYu-Jia, PangJin-Shu, LiaoWei, HeYun, LinZhang-Ya, YangHong

CD8 T-cell infiltration
Improved rGBM survival

High CD8 T-cell infiltration is a promising prognostic biomarker for recurrent glioblastoma, and it may be helpful in selecting treatment options.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

Lomustine and Bevacizumab in Progressive Glioblastoma.

Author: WickWolfgang, GorliaThierry, BendszusMartin, TaphoornMartin, SahmFelix, HartingInga, BrandesAlba A, TaalWalter, DomontJulien, IdbaihAhmed, CamponeMario, ClementPaul M, StuppRoger, FabbroMichel, Le RhunEmilie, DuboisFrancois, WellerMichael, von DeimlingAndreas, GolfinopoulosVassilis, BrombergJacoline C, PlattenMichael, KleinMartin, van den BentMartin J

Glioblastoma survival

This study aimed to determine whether combining bevacizumab with lomustine would result in longer overall survival than lomustine alone in patients with glioblastoma at first progression.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

11.

IDH-Mutant Low-grade Glioma: Advances in Molecular Diagnosis, Management, and Future Directions.

Author: DonoAntonio, BallesterLeomar Y, PrimdahlDitte, EsquenaziYoshua, BhatiaAnkush

Improved survival
Neurocognitive side effects
Quality of life

IDH-mutant low-grade gliomas (LGG) have a favorable survival compared to IDH-WT glioma. Radiotherapy with subsequent PCV provides longer overall survival compared to radiotherapy alone.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Early treatment response evaluation using FET PET compared to MRI in glioblastoma patients at first progression treated with bevacizumab plus lomustine.

Author: GalldiksNorbert, DunklVeronika, CecconGarry, TscherpelCaroline, StoffelsGabriele, LawIan, HenriksenOtto M, MuhicAida, PoulsenHans S, StegerJan, BauerElena K, LohmannPhilipp, SchmidtMatthias, ShahNadim J, FinkGereon R, LangenKarl-Josef

Early response identification

Fluoro-ethyl-tyrosine (FET)-positron emission tomography (PET) was more useful than magnetic resonance imaging (MRI) in identifying responders to bevacizumab/lomustine treatment for glioblastoma early after treatment initiation.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

High-Density Lipoprotein-Mimicking Nanodiscs for Chemo-immunotherapy against Glioblastoma Multiforme.

Author: KadiyalaPadma, LiDan, NuñezFernando M, AltshulerDavid, DohertyRobert, KuaiRui, YuMinzhi, KamranNeha, EdwardsMarta, MoonJames J, LowensteinPedro R, CastroMaria G, SchwendemanAnna

GBM treatment
Immunological memory
Survival
Tumor regression

This study investigated the potential of synthetic HDL nanodiscs as a drug delivery platform for treating glioblastoma multiforme (GBM). The study found that delivering docetaxel (DTX) and CpG, a TLR9 agonist, via sHDL nanodiscs to the tumor microenvironment led to tumor regression and antitumor CD8+ T cell responses. Combining this treatment with radiation resulted in long-term survival in 80% of GBM-bearing animals.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

16.

One year of procarbazine lomustine and vincristine is poorly tolerated in low grade glioma: a real world experience in a national neuro-oncology centre.

Author: KeoghRachel J, AslamRazia, HennessyMaeve A, CoyneZac, HennessyBryan T, BreathnachOscar S, GroganLiam, MorrisPatrick G

LGG treatment
LGG
chemotherapy side effects

PCV chemotherapy is an effective adjuvant therapy for low-grade glioma, but its tolerability in routine clinical practice is not well understood.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Risk Factors for Small Adult Height in Childhood Cancer Survivors.

Author: Demoor-GoldschmidtCharlotte, AllodjiRodrigue S, JournyNeige, RubinoCarole, ZrafiWael Salem, DebicheGhazi, LlanasDamien, VeresCristina, Thomas-TeinturierCécile, PacquementHélène, Vu-BezinGiao, FresneauBrice, BercheryDelphine, BolleStephanie, DialloIbrahima, HaddyNadia, de VathaireFlorent

Improved growth
Growth hormone deficiency
Small adult height

Childhood cancer survivors are at a high risk of small adult height (SAH) due to impaired growth. This study found that 9.2% of childhood cancer survivors experienced SAH. Factors that increased the risk of SAH include being young at the time of cancer treatment, being short at diagnosis, pituitary irradiation, and treatment with busulfan or lomustine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Radiotherapy versus radiotherapy combined with temozolomide in high-risk low-grade gliomas after surgery: study protocol for a randomized controlled clinical trial.

Author: WangJingjing, WangYing, HeYan, GuanHui, HeLing, MuXiaoli, PengXingchen

Improved OS
Improved PFS

This clinical trial aims to confirm whether radiation therapy combined with temozolomide improves progression-free survival (PFS) and overall survival (OS) in high-risk patients with low-grade gliomas (LGGs).

Clinical Trial ProtocolA plan for conducting a clinical trial. It describes in detail the purpose, design, methodology, and statistical considerations of the trial, ensuring the transparency and consistency of the trial.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

20.

Multicenter pilot study of radiochemotherapy as first-line treatment for adults with medulloblastoma (NOA-07).

Author: BeierDagmar, ProescholdtMartin, ReinertChristiane, PietschTorsten, JonesDavid T W, PfisterStefan M, HattingenElke, SeidelClemens, DirvenLinda, LuerdingRalf, ReijneveldJaap, Warmuth-MetzMonika, BonsantoMatteo, BremerMichael, CombsStephanie E, RiekenStefan, HerrlingerUlrich, KuntzeHolger, Mayer-SteinackerRegine, MoskoppDag, SchneiderThomas, BeringerAndreas, SchlegelUwe, StummerWalter, WelkerHelmut, WeyerbrockAstrid, PaulsenFrank, RutkowskiStefan, WellerMichael, WickWolfgang, KortmannRolf-Dieter, BogdahnUlrich, HauPeter

Medulloblastoma in adults is rare, with only 0.6 cases per million. Prognosis depends on the specific subtype of medulloblastoma and clinical factors. This study evaluated the feasibility and toxicity of radio-polychemotherapy in a prospective trial.

Clinical Trial, Phase IIA Phase II trial is a trial that further evaluates the efficacy and safety of a new drug or treatment, whose safety has been confirmed to some extent in a Phase I trial, in a small number of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Treatment options for progression or recurrence of glioblastoma: a network meta-analysis.

Author: McBainCatherine, LawrieTheresa A, RogozińskaEwelina, KernohanAshleigh, RobinsonTomos, JefferiesSarah

GBM treatment

Glioblastoma (GBM) is an aggressive brain tumor with limited treatment options after initial therapy. Research is ongoing to identify the best treatment for patients experiencing disease progression or recurrence.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

25.

Hemorrhagic diathesis and bone marrow aplasia secondary to lomustine overdose in a dog.

Author: HenkerLuan C, KemperRegina T, BianchiSimone P, BandinelliMarcele B, PavariniSaulo P

Bone marrow aplasia
Hemorrhages

This report describes a fatal case of lomustine overdose in a dog. The dog, mistakenly administered a significantly higher dose of lomustine, developed severe thrombocytopenia and leukopenia, leading to multifocal hemorrhages and bone marrow aplasia.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

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