An Overview of Fotemustine in High-Grade Gliomas: From Single Agent to Association with Bevacizumab

Table 1

The most important studies on fotemustine treatment before temozolomide era.

Authors	PTS	Median age	Median; KPS	Types of gliomas	Prior treatment	FTM schedule	Line of FTM treatment	DCR	PFS	OS	Grades 3-4 toxicity
Frenay et al., 1991 [8]	38	49 (18–65)	70 (50–100%)	GBM (53%), AA (24%), others (23%)	Surgery^§ (71%), RT (100%), CT (26%)	Standard*	1st and 2nd	73% (PR 26%, SD 47%)	21–32.7 wks	40–42 wks	Thrombocytopenia 23%; leukopenia 17%; nausea 8.6%
Ozkan et al., 2004 [9]	27	46 (23–70)	NA	GBM (63%), AA (37%)	Surgery^§ (100%), RT (100%)	FTM 100 mg/m^2 every 3 weeks	1st	NA	8 ms	11 ms	Thrombocytopenia 7%
Fazeny-Dörner et al., 2003 [10]	31	50 (23–65)	70 (NA)	GBM (100%)	Surgery^§ (100%), RT (100%), CT (100%)	FTM 100 mg/m^2 every + D 200 mg/m^2 every 3 wks	2nd	55% (PR 3%, SD 52%)	17 wks	45 wks	Thrombocytopenia 10%; leukopenia 3%
Boiardi et al., 2001 [11]	16	54 (20–63)	80 (70–100)	GBM (69%), AA (25%), AOA (6%)	Surgery^§ (94%), RT (100%), CT (94%)	FTM 125 mg/m^2 day 4 + PCZ 300 mg/day for 4 days, every 4 weeks	2nd	50% (PR 6%, SD 44%)	2.6 ms	9.7 ms	Thrombocytopenia 17%; leukopenia 17%; anemia 33%
Frenay et al., 2000 [12]	33	58 (20–73)	NA	GBM (100%)	None	FTM 100 mg/m^2 day 1, CDDP 33 mg/m^2 days 1–3, VP16 75 mg/m^2 days 1–3, monthly	1st	79% (CR 3%, PR 24%, SD 52%)	NA	10 ms	Thrombocytopenia or leukopenia 36%

FTM: fotemustine; KPS: Karnofsky performance status; RT: radiation therapy; CT: chemotherapy; PTS: patients; PFS: progression-free survival; OS: overall survival; DCR: disease control rate; GBM: glioblastoma; AA: anaplastic astrocytoma; AOA: anaplastic oligoastrocytoma; PCZ: procarbazine; CDDP: cisplatin; VP16: etoposide; D: dacarbazine; wk: week; ms: months, CR: complete response; SD: stable disease; PR: partial response; NA: not available.
∗Standard: FTM 100 mg/m² every week for 3 consecutive weeks followed by a 5-week rest period, subsequently, an infusion every 3 weeks; §Surgery: complete or partial resection.