Polifeprosan 20, 3.85% carmustine slow release wafer in malignant glioma: patient selection and perspectives on a low-burden therapy

Figures & data

Figure 1 Carmustine wafers implanted in a glioblastoma resection cavity.

Table 1 Outcome of randomized trials assessing adjuvant use of carmustine implants or temozolomide compared with control adjuvant radiation arms

Control arms	Control arms (RT)				Experimental arms (RT plus BCNU implant or RT and temozolomide)
Study	Number	Median survival (months)	2-year survival (%)	3-year survival (%)	Number	Median survival (months)	2-year survival (%)	3-year survival (%)
Westphal et al (control, placebo wafer, and RT)^Citation3,a	120 (placebo wafer and RT)	11.6	8.3	1.7	120 (BCNU wafer and RT)	13.8	15.8	9
EORTC: (control, RT alone)^Citation18,Citation76	286 (RT alone)	12.1	10.9	4.4	287 (RT and TMZ)	14.6	27	16
EORTC: biopsy only subgroup	45	7.8	4.6	4.6	48	9.4	10.4	7.8
EORTC: partial resect subgroup	128	11.7	9.4	3.7	126	13.5	23.7	14.3
EORTC: complete resect subgroup	113	14.2	15.0	5.3	113	18.8	38.4	21.4

Notes: Copyright ©2012. Dove Medical Press. Reproduced from Kleinberg L. Polifeprosan 20, 3.85% carmustine slow-release wafer in malignant glioma: evidence for role in era of standard adjuvant temozolomide. Core Evid. 2012;7:115–130.¹⁶

a Results based on extent of resection not available for polymer study. Most would have had substantial or total debulking of gross disease based on intraoperative assessment.

Abbreviations: RT, radiotherapy; BCNU, carmustine; EORTC, European Organization for Research and Treatment of Cancer; TMZ, temozolomide; resect, resection.

WestphalMHiltDCBorteyEA phase 3 trial of local chemotherapy with biodegradable carmustine (BCNU) wafers (Gliadel wafers) in patients with primary malignant gliomaNeuro Oncol200352798812672279

 PubMed Web of Science ®Google Scholar

StuppRHegiMEMasonWPEffects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trialLancet Oncol200910545946619269895

 PubMed Web of Science ®Google Scholar

StuppRGanderMLeyvrazSNewlandsECurrent and future developments in the use of temozolomide for the treatment of brain tumoursLancet Oncol20012955256011905710

 PubMed Web of Science ®Google Scholar

KleinbergLPolifeprosan 20, 3.85% carmustine slow-release wafer in malignant glioma: evidence for role in era of standard adjuvant temozolomideCore Evid2012711513023118709

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