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November 1976

Single-Agent Chemotherapy of Brain Tumors: A Five-Year Review

Author Affiliations

From the departments of neurological surgery (Drs Wilson, Gutin, Boldrey, Levin, Enot, and Crafts), neurology (Dr Levin), and pharmaceutical chemistry (Dr Levin), University of California School of Medicine, San Francisco.

Arch Neurol. 1976;33(11):739-744. doi:10.1001/archneur.1976.00500110007002

• Identification of effective single chemotherapeutic agents for brain tumors must precede the rational use of multiple drug combinations. In phase 2 trials beginning in 1968, 158 patients with intrinsic brain tumors (mostly recurrent malignant astrocytomas) were considered evaluable.

The larger trials with more effective drugs produced these results: carmustine (BCNU) response rate, 47%, with median duration of nine months; lomustine (CCNU), 44%, with median duration of six months; procarbazine hydrochloride, 52%, with median duration six months; carmustine and vincristine sulfate combined, 44%, with median duration of only four months; and BIC (5-[3,3-bis(2-chloroethyl)-1-triazeno]imidazole-4-carboxamide), 38%, with median duration of five months. Administration of glucocorticoids was not found to bias the frequency of response.

Forty-seven patients, 26 of whom had responded to the initial drug, received a second drug. Among 26 patients who were evaluable, only four responded to the second drug.

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