© 2001 by Society
© 2001 by the Society forNeuro-Oncology
Importance of dose intensity in neurooncology clinical trials: SummaryReport of the Sixth Annual Meeting of the Blood-Brain Barrier DisruptionConsortium
Department of Neurology, Oregon Health SciencesUniversity, Portland, OR 97201-3098 (N.D.D., P.G., L.L.M., E.A.N.); Childrens Center for Cancer and Blood Diseases, ChildrensHospital of Los Angeles, Los Angeles, CA 90027 (C.P.A.); Department of Pediatrics, M.D. Anderson Cancer Center,Houston, TX 99030 (W.A.B.); London Regional CancerCenter, London, Ontario, Canada N6A 4L6 (J.G.C.); Neuro-Oncology Program, University of California, ReedNeurological Research Center, Los Angeles, CA 90095-1769 (T.C.); University of Pennsylvania Medical Center, Philadelphia, PA19104-6160 (S.L.E.); Department of Neurosurgery,University of Minnesota, Minneapolis, MN 55455 (W.A.H.); Department of Neurosurgery, Medical University of SouthCarolina, Charleston, SC 29425-2272 (S.J.P.); Hematology and Medical Oncology, Cleveland ClinicFoundation, Cleveland, OH 44195 (D.P.); Neuro-Oncology Center, Hadassah Hebrew UniversityHospital, Jerusalem, Israel 91120 (T.S.)
2 Address correspondence and reprint requests to Edward A. Neuwelt, OregonHealth Sciences University, Department of Neurology, 3181 S.W. Sam JacksonPark Rd.-L603, Portland, OR 97201-3098.
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Abstract |
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Therapeutic options for the treatment of malignant brain tumors have beenlimited, in part, because of the presence of the blood-brain barrier. For thisreason, the Sixth Annual Meeting of the Blood-Brain Barrier DisruptionConsortium, the focus of which was the "Importance of Dose Intensity inNeuro-Oncology Clinical Trials," was convened in April 2000, atGovernment Camp, Mount Hood, Oregon. This meeting, which was supported by theNational Cancer Institute, the National Institute of Neurological Disordersand Stroke, and the National Institute of Deafness and Other CommunicationDisorders, brought together clinicians and basic scientists from across theU.S. to discuss the role of dose intensity and enhanced chemotherapy deliveryin the treatment of malignant brain tumors and to design multicenter clinicaltrials. Optimizing chemotherapy delivery to the CNS is crucial, particularlyin view of recent progress identifying certain brain tumors as chemosensitive.The discovery that specific constellations of genetic alterations can predictwhich tumors are chemoresponsive, and can therefore more accurately predictprognosis, has important implications for delivery of intensive, effectivechemotherapy regimens with acceptable toxicities. This report summarizes thediscussions, future directions, and key questions regarding dose-intensivetreatment of primary CNS lymphoma, CNS relapse of systemic non-Hodgkin'slymphoma, anaplastic oligodendroglioma, high-grade glioma, and metastaticcancer of the brain. The promising role of cytoenhancers and chemo-protectantsas part of dose-intensive regimens for chemosensitive brain tumors anddevelopment of improved gene therapies for malignant gliomas arediscussed.
Received June 22, 2000; Accepted August 24, 2000
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