Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma

Long-term results of RTOG 9402

Gregory Cairncross, Meihua Wang, Edward Shaw, Robert Brian Jenkins, David Brachman, Jan Craig Buckner, Karen Fink, Luis Souhami, Normand Laperriere, Walter Curran, Minesh Mehta

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Abstract

Purpose: Anaplastic oligodendrogliomas, pure (AO) and mixed (anaplastic oligoastrocytoma [AOA]), are chemosensitive, especially if codeleted for 1p/19q, but whether patients live longer after chemoradiotherapy is unknown Patients and Methods: Eligible patients with AO/AOA were randomly assigned to procarbazine, lomustine, and vincristine (PCV) plus radiotherapy (RT) versus RT alone. The primary end point was overall survival (OS) Results: Two hundred ninety-one eligible patients were randomly assigned: 148 to PCV plus RT and 143 to RT. For the entire cohort, there was no difference in median survival by treatment (4.6 years for PCV plus RT v 4.7 years for RT; hazard ratio [HR] = 0.79; 95% CI, 0.60 to 1.04; P =.1). Patients with codeleted tumors lived longer than those with noncodeleted tumors (PCV plus RT: 14.7 v2.6 years, HR = 0.36, 95% CI, 0.23 to 0.57, P <.001; RT: 7.3 v 2.7 years, HR = 0.40, 95% CI, 0.27 to 0.60, P <.001), and the median survival of those with codeleted tumors treated with PCV plus RT was twice that of patients receiving RT (14.7 v7.3 years; HR = 0.59; 95% CI, 0.37 to 0.95; P =.03). For those with noncodeleted tumors, there was no difference in median survival by treatment arm (2.6 v 2.7 years; HR = 0.85; 95% CI, 0.58 to 1.23; P =.39). In Cox models that ncluded codeletion status, the adjusted OS for all patients was prolonged by PCV plus RT (HR = 0.67; 95% CI, 0.50 to 0.91; P =.01) Conclusion: For the subset of patients with 1p/19q codeleted AO/AOA, PCV plus RT may be an especially effective treatment, although this observation was derived from an unplanned analysis.

Original languageEnglish (US)
Pages (from-to)337-343
Number of pages7
JournalJournal of Clinical Oncology
Volume31
Issue number3
DOIs
StatePublished - Jan 20 2013

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Oligodendroglioma
Chemoradiotherapy
Lomustine
Procarbazine
Radiotherapy
Vincristine
Survival
Neoplasms
Astrocytoma
Proportional Hazards Models
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma : Long-term results of RTOG 9402. / Cairncross, Gregory; Wang, Meihua; Shaw, Edward; Jenkins, Robert Brian; Brachman, David; Buckner, Jan Craig; Fink, Karen; Souhami, Luis; Laperriere, Normand; Curran, Walter; Mehta, Minesh.

In: Journal of Clinical Oncology, Vol. 31, No. 3, 20.01.2013, p. 337-343.

Research output: Contribution to journalArticle

Cairncross, G, Wang, M, Shaw, E, Jenkins, RB, Brachman, D, Buckner, JC, Fink, K, Souhami, L, Laperriere, N, Curran, W & Mehta, M 2013, 'Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma: Long-term results of RTOG 9402', Journal of Clinical Oncology, vol. 31, no. 3, pp. 337-343. https://doi.org/10.1200/JCO.2012.43.2674
Cairncross, Gregory ; Wang, Meihua ; Shaw, Edward ; Jenkins, Robert Brian ; Brachman, David ; Buckner, Jan Craig ; Fink, Karen ; Souhami, Luis ; Laperriere, Normand ; Curran, Walter ; Mehta, Minesh. / Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma : Long-term results of RTOG 9402. In: Journal of Clinical Oncology. 2013 ; Vol. 31, No. 3. pp. 337-343.
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abstract = "Purpose: Anaplastic oligodendrogliomas, pure (AO) and mixed (anaplastic oligoastrocytoma [AOA]), are chemosensitive, especially if codeleted for 1p/19q, but whether patients live longer after chemoradiotherapy is unknown Patients and Methods: Eligible patients with AO/AOA were randomly assigned to procarbazine, lomustine, and vincristine (PCV) plus radiotherapy (RT) versus RT alone. The primary end point was overall survival (OS) Results: Two hundred ninety-one eligible patients were randomly assigned: 148 to PCV plus RT and 143 to RT. For the entire cohort, there was no difference in median survival by treatment (4.6 years for PCV plus RT v 4.7 years for RT; hazard ratio [HR] = 0.79; 95{\%} CI, 0.60 to 1.04; P =.1). Patients with codeleted tumors lived longer than those with noncodeleted tumors (PCV plus RT: 14.7 v2.6 years, HR = 0.36, 95{\%} CI, 0.23 to 0.57, P <.001; RT: 7.3 v 2.7 years, HR = 0.40, 95{\%} CI, 0.27 to 0.60, P <.001), and the median survival of those with codeleted tumors treated with PCV plus RT was twice that of patients receiving RT (14.7 v7.3 years; HR = 0.59; 95{\%} CI, 0.37 to 0.95; P =.03). For those with noncodeleted tumors, there was no difference in median survival by treatment arm (2.6 v 2.7 years; HR = 0.85; 95{\%} CI, 0.58 to 1.23; P =.39). In Cox models that ncluded codeletion status, the adjusted OS for all patients was prolonged by PCV plus RT (HR = 0.67; 95{\%} CI, 0.50 to 0.91; P =.01) Conclusion: For the subset of patients with 1p/19q codeleted AO/AOA, PCV plus RT may be an especially effective treatment, although this observation was derived from an unplanned analysis.",
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T1 - Phase III trial of chemoradiotherapy for anaplastic oligodendroglioma

T2 - Long-term results of RTOG 9402

AU - Cairncross, Gregory

AU - Wang, Meihua

AU - Shaw, Edward

AU - Jenkins, Robert Brian

AU - Brachman, David

AU - Buckner, Jan Craig

AU - Fink, Karen

AU - Souhami, Luis

AU - Laperriere, Normand

AU - Curran, Walter

AU - Mehta, Minesh

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Y1 - 2013/1/20

N2 - Purpose: Anaplastic oligodendrogliomas, pure (AO) and mixed (anaplastic oligoastrocytoma [AOA]), are chemosensitive, especially if codeleted for 1p/19q, but whether patients live longer after chemoradiotherapy is unknown Patients and Methods: Eligible patients with AO/AOA were randomly assigned to procarbazine, lomustine, and vincristine (PCV) plus radiotherapy (RT) versus RT alone. The primary end point was overall survival (OS) Results: Two hundred ninety-one eligible patients were randomly assigned: 148 to PCV plus RT and 143 to RT. For the entire cohort, there was no difference in median survival by treatment (4.6 years for PCV plus RT v 4.7 years for RT; hazard ratio [HR] = 0.79; 95% CI, 0.60 to 1.04; P =.1). Patients with codeleted tumors lived longer than those with noncodeleted tumors (PCV plus RT: 14.7 v2.6 years, HR = 0.36, 95% CI, 0.23 to 0.57, P <.001; RT: 7.3 v 2.7 years, HR = 0.40, 95% CI, 0.27 to 0.60, P <.001), and the median survival of those with codeleted tumors treated with PCV plus RT was twice that of patients receiving RT (14.7 v7.3 years; HR = 0.59; 95% CI, 0.37 to 0.95; P =.03). For those with noncodeleted tumors, there was no difference in median survival by treatment arm (2.6 v 2.7 years; HR = 0.85; 95% CI, 0.58 to 1.23; P =.39). In Cox models that ncluded codeletion status, the adjusted OS for all patients was prolonged by PCV plus RT (HR = 0.67; 95% CI, 0.50 to 0.91; P =.01) Conclusion: For the subset of patients with 1p/19q codeleted AO/AOA, PCV plus RT may be an especially effective treatment, although this observation was derived from an unplanned analysis.

AB - Purpose: Anaplastic oligodendrogliomas, pure (AO) and mixed (anaplastic oligoastrocytoma [AOA]), are chemosensitive, especially if codeleted for 1p/19q, but whether patients live longer after chemoradiotherapy is unknown Patients and Methods: Eligible patients with AO/AOA were randomly assigned to procarbazine, lomustine, and vincristine (PCV) plus radiotherapy (RT) versus RT alone. The primary end point was overall survival (OS) Results: Two hundred ninety-one eligible patients were randomly assigned: 148 to PCV plus RT and 143 to RT. For the entire cohort, there was no difference in median survival by treatment (4.6 years for PCV plus RT v 4.7 years for RT; hazard ratio [HR] = 0.79; 95% CI, 0.60 to 1.04; P =.1). Patients with codeleted tumors lived longer than those with noncodeleted tumors (PCV plus RT: 14.7 v2.6 years, HR = 0.36, 95% CI, 0.23 to 0.57, P <.001; RT: 7.3 v 2.7 years, HR = 0.40, 95% CI, 0.27 to 0.60, P <.001), and the median survival of those with codeleted tumors treated with PCV plus RT was twice that of patients receiving RT (14.7 v7.3 years; HR = 0.59; 95% CI, 0.37 to 0.95; P =.03). For those with noncodeleted tumors, there was no difference in median survival by treatment arm (2.6 v 2.7 years; HR = 0.85; 95% CI, 0.58 to 1.23; P =.39). In Cox models that ncluded codeletion status, the adjusted OS for all patients was prolonged by PCV plus RT (HR = 0.67; 95% CI, 0.50 to 0.91; P =.01) Conclusion: For the subset of patients with 1p/19q codeleted AO/AOA, PCV plus RT may be an especially effective treatment, although this observation was derived from an unplanned analysis.

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