Summary
Purpose
Because raised matrix metalloprotease (MMP) levels are associated with glioma invasion and angiogenesis, we tested the efficacy of marimastat (MT) an orally active drug that can reduce MMP levels, in patients with gliomas.
Patients and Methods
A total of 162 patients with intracranial glioblastoma multiforme or gliosarcomas who had undergone surgery and radiotherapy participated in this multicenter, double-blind, placebo-controlled, parallel group study conducted at 20 institutions. Seventy-nine patients (57 male, 22 female, median age 58 years) were randomized to receive placebo (PB), and 83 patients (51 male, 32 female, median age 57 years) were randomized to receive MT, 10 mg orally twice daily, until tumor progression.
Results
This intention-to-treat efficacy analysis showed no statistically significant difference between MT and PB groups with respect to survival (P=0.38, log rank test). The median survival time from protocol initiation was 37.9 weeks for the PB group and 42.9 weeks for the MT group, with a hazard ratio of 1.16 (95% CI 0.83 to 1.60). There were no statistically significant differences in quality of life between the PB and MT groups, as assessed by the FACT-BR questionnaire. Musculoskeletal toxicities led to dose modification or withdrawal in 20% of MT-treated and 1.2% of PB-treated patients.
Conclusion
MT does not improve survival in patients with glioblastoma or gliosarcoma following surgery and radiotherapy. Therefore, single-agent MT appears unwarranted; however, MT in combination with cytotoxic chemotherapy may be warranted, as suggested by observations in our study and other studies.
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Acknowledgement
We would like to thank Betty Notzon for editorial assistance and Melissa McLane for manuscript preparation.
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★This work was presented in part at the 37th Annual Meeting of the American Society of Clinical Oncology, San Francisco, CA, on May 13, 2001, and supported by British Biotech Pharmaceuticals, Watlington Road, Oxford, OX4 6LY, UK. No author currently has a financial interest in Marimastat. Mark Baillet is currently with Origin Pharmaceutical Services Ltd.
*Participating institutions are listed in Table 1. Clinician authorship required ≥10 patient accrual from participating institution.
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Levin, V.A., Phuphanich, S., Alfred Yung, W. et al. Randomized, double-blind, placebo-controlled trial of marimastat in glioblastoma multiforme patients following surgery and irradiation★ . J Neurooncol 78, 295–302 (2006). https://doi.org/10.1007/s11060-005-9098-5
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DOI: https://doi.org/10.1007/s11060-005-9098-5