Nimotuzumab (Theraloc(R)) in the Treatment of Children and Adults High Malignant Brain Tumors

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  Rational: EGF-R is the most consistently expressed cell surface marker for glioblastoma.Therapies are directed against the intercellular signalling pathway or the cell surface binding of the cognate ligands.a) This phase Ⅲ trial was designed to explore the safety and efficacy of the monoclonal anti-EGFR antibody nimotuzumab in combination with a standard radiotherapy in the treatment of patients with a newly diagnosed DIPG From 2006 to 2007 forty-one eligible patients (median 7 years) were enrolled in the study.Patients received induction therapy; consolidation therapy Ⅰ and Ⅱ were administered in 31 and 15 patients, respectively.Best responses were PR in 4 patients (9.8%) and SD in 27 patients (65.8%).Median PFS and OS were 5.5±0.2m and 9.6±1.0m, respectively, with a significant longer OS in radiological responders than in non-responders (p=0.004).QL analysis showed a trend of amelioration.Adverse events were mostly mild.Repeated applications ofnimotuzumab concomitantly to radiotherapy were safe.This combination therapy has cytotoxic efficacy in the majority of patients.b) Methods : Nimotuzumab is tested in an open label, randomized, muticenter Phase Ⅲ trial in adult patients with newly diagnosed glioblastoma.Patients with histologically confirmed glioblastoma were included without specification of resection status.Primary endpoint was time to progression.Overall survival serves as a secondary endpoint with quality of life and safety as additional parameters.Results : Between August 2008 and December 2010, 130 patients were enrolled with 150 subjects as a targeted total study population.60 patients had a gross total resection with no residual contrast enhancement and 70 patients had partial resections with residual contrast enhancement.AEs and SAEs being the same in both study arms.No rash, conjunctivitis or mucositis were reported.
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