首页|Treatment of glioblastoma with re-purposed renin-angiotensin system modulators: Results of a phase I clinical trial

Treatment of glioblastoma with re-purposed renin-angiotensin system modulators: Results of a phase I clinical trial

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  • NSTL
  • Elsevier
Glioblastoma is the most common and most aggressive primary brain cancer in adults. Standard treatment of glioblastoma consisting of maximal safe resection, adjuvant radiotherapy and chemotherapy with temozolomide, results in an overall median survival of 14.6 months. The aggressive nature of glioblastoma has been attributed to the presence of glioblastoma stem cells which express components of the renin-angiotensin system (RAS). This phase I clinical trial investigated the tolerability and efficacy of a treatment targeting the RAS and its converging pathways in patients with glioblastoma. Patients who had relapsed following standard treatment of glioblastoma who met the trial criteria were commenced on dose-escalated oral RAS modulators (propranolol, aliskiren, cilazapril, celecoxib, curcumin with piperine, aspirin, and metformin). Of the 17 patients who were enrolled, ten completed full dose-escalation of the treatment. The overall median survival was 19.9 (95% CI:14.1-25.7) months. Serial FET-PET/CTs showed a reduction in both tumor volume and uptake in one patient, an increase in tumor uptake in nine patients with decreased (n = 1), unchanged (n = 1) and increased (n = 7) tumor volume, in the ten patients who had completed full dose-escalation of the treatment. Two patients experienced mild side effects and all patients had preservation of quality of life and performance status during the treatment. There is a trend towards increased survival by 5.3 months although it was not statistically significant. These encouraging results warrant further clinical trials on this potential novel, well-tolerated and costeffective therapeutic option for patients with glioblastoma. (c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

GlioblastomaGlioblastoma stem cellsRenin-angiotensin systemRenin-angiotensin system inhibitorsRenin-angiotensin system modulatorsDrug re-purposingCANCER STEM-CELLSNERVOUS-SYSTEMCATHEPSIN-BCURCUMINRADIOTHERAPYTEMOZOLOMIDEMULTIFORMETHERAPYBENEFITTARGET

O'Rawe, Michael、Wickremesekera, Agadha C.、Pandey, Ramesh、Young, David、Sim, Dalice、FitzJohn, Trevor、Burgess, Carl、Kaye, Andrew H.、Tan, Swee T.

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Gillies McIndoe Res Inst

Dept Radiat Oncol,Palmerston North Hosp

Dept Neurosurg,Hadassah Hebrew Univ

2022

10.1016/j.jocn.2021.11.023

Journal of clinical neuroscience

Journal of clinical neuroscience

SCI
ISSN：0967-5868
年,卷(期)：2022.95
  • 5
  • 52