L-boronophenylalanine-mediated boron neutron capture therapy for malignant glioma progressing after external beam radiation therapy: a Phase I study.

Abstract

PURPOSE:

To investigate the safety of boronophenylalanine-mediated boron neutron capture therapy (BNCT) in the treatment of malignant gliomas that progress after surgery and conventional external beam radiation therapy.

METHODS AND MATERIALS:

Adult patients who had histologically confirmed malignant glioma that had progressed after surgery and external beam radiotherapy were eligible for this Phase I study, provided that >6 months had elapsed from the last date of radiation therapy. The first 10 patients received a fixed dose, 290 mg/kg, of L-boronophenylalanine-fructose (L-BPA-F) as a 2-hour infusion before neutron irradiation, and the remaining patients were treated with escalating doses of L-BPA-F, either 350 mg/kg, 400 mg/kg, or 450 mg/kg, using 3 patients on each dose level. Adverse effects were assessed using National Cancer Institute Common Toxicity Criteria version 2.0.

RESULTS:

Twenty-two patients entered the study. Twenty subjects had glioblastoma, and 2 patients had anaplastic astrocytoma, and the median cumulative dose of prior external beam radiotherapy was 59.4 Gy. The maximally tolerated L-BPA-F dose was reached at the 450 mg/kg level, where 4 of 6 patients treated had a grade 3 adverse event. Patients who were given >290 mg/kg of L-BPA-F received a higher estimated average planning target volume dose than those who received 290 mg/kg (median, 36 vs. 31 Gy [W, i.e., a weighted dose]; p = 0.018). The median survival time following BNCT was 7 months.

CONCLUSIONS:

BNCT administered with an l-BPA-F dose of up to 400 mg/kg as a 2-hour infusion is feasible in the treatment of malignant gliomas that recur after conventional radiation therapy.

• Authors: Leena Kankaanranta, Tiina Seppälä, Hanna Koivunoro, Petteri Välimäki, Annette Beule, Juhani Collan, Mika Kortesniemi, Jouni Uusi-Simola, Petri Kotiluoto, Iiro Auterinen, Tom Serèn, Anders Paetau, Kauko Saarilahti, Sauli Savolainen, Heikki Joensuu
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 80 Issue 2 Pg. 369-76 (Jun 01 2011) ISSN: 1879-355X [Electronic] United States
• PMID: 21236605 (Publication Type: Clinical Trial, Phase I, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• 4-boronophenylalanine-fructose
• Boron Compounds
• Radiation-Sensitizing Agents
• Fructose

Topics

• Adult
• Aged
• Astrocytoma (mortality, pathology, radiotherapy, surgery)
• Boron Compounds (administration & dosage, adverse effects, therapeutic use)
• Boron Neutron Capture Therapy (adverse effects, methods, mortality)
• Brain Neoplasms (mortality, pathology, radiotherapy, surgery)
• Disease Progression
• Female
• Fructose (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Glioblastoma (mortality, pathology, radiotherapy, surgery)
• Humans
• Male
• Maximum Tolerated Dose
• Middle Aged
• Radiation-Sensitizing Agents (adverse effects, therapeutic use)
• Radiotherapy Dosage
• Young Adult