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*For medical professionals only
2022 CSCO Pre-"Research" Express, Professor Guo Chengcheng shared the new progress
of podophyllotoxin chemotherapy treatment.
The 25th National Congress of Clinical Oncology and the 2022 Chinese Society of Clinical Oncology (CSCO) Annual Conference, co-hosted by the Chinese Society of Clinical Oncology and Beijing Heesco Clinical Oncology Research Foundation, were presented
in the form of a combination of online + offline from November 5 to 12, 2022.
On November 12, the CSCO Annual Meeting on Nervous System Tumors was chaired by Professor Mou Yongjie, Chairman of the CSCO Neurological Oncology Expert Committee and Sun
Yat-sen University Cancer Prevention and Treatment Center 。 At the beginning of the conference, Professor Mou Yongjie made a wonderful opening speech, and then co-chaired the conference with Professor Qiu Xiaoguang, Chair-designate of China Glioma Collaborative Group, Beijing Tiantan Hospital affiliated to Capital Medical University, Vice Chairman of CSCO Neurological Oncology Committee, Professor Si Lu of Peking University Cancer Hospital, Vice Chairman of CSCO Neuro-Oncology Professional Committee, and Professor Wan Jinghai of Cancer Hospital of Chinese Academy of Medical Sciences as the host of the
conference.
At the meeting, Professor Guo Chengcheng of the Cancer Prevention and Treatment Center of Sun Yat-sen University delivered a wonderful report on "New Progress of Podophyllotoxin Chemotherapy Drugs in the Treatment of Central Nervous System Malignant Tumors", and interpreted the new progress
of teniposide in the treatment of glioma for scholars.
"Medical Community" has compiled and presented wonderful content for readers
.
Figure 1: Professor Guo Chengcheng delivered a report at the CSCO conference
It is also a podophyllotoxin chemotherapy drug, and teniposide highlights its advantages
Professor Guo first explained in detail the mechanism
of podophyllotoxin chemotherapy drugs in the field of glioma.
She said that teniposide is a semi-synthetic podophyllotoxin glycan derivative, derived from the parent compound podophyllotoxin (PTOX), which belongs to topoisomerase II inhibitors
.
Figure 2.
The mechanism of action of podophyllotoxin chemotherapy drugs teniposide is similar to similar drugs, but compared with other similar drugs, teniposide also has the advantages of high fat solubility, small molecular weight, etc.
, and has better central permeability, which is suitable for the treatment of brain metastases of
glioma and other malignant tumors.
It was approved by the US Food and Drug Administration (FDA) in 1992
.
Teniposide remains one of the important options for glioma treatment options
Glioma is one of the most common malignancies of the
central nervous system.
Among them, the median survival time of low-grade glioma [World Health Organization (WHO) grade I and II.
] was 5-8 years; High-grade gliomas (WHO grade III.
, IV.
), called malignant gliomas, are more common in brain gliomas and have a poor prognosis, the median survival time of grade III glioma is about 3 years, the median survival time of grade IV is only 12-18 months, and the survival time of patients older than 60 years is shorter [3].
In the report, Professor Guo introduced in detail the research results of teniposide in the treatment of glioma, teniposide combined with nitrosourea for the treatment of WHO grade III.
-IV.
glioma, teniposide combined with cisplatin for recurrent high-grade glioma, teniposide for mutant (IDHmut) glioma and other teniposide-containing regimens can bring certain survival benefits and controllable
safety to glioma patients.
Based on the good performance of teniposide in glioma-related clinical research, domestic guidelines such as the Chinese Guidelines for the Diagnosis and Treatment of Central Nervous System Glioma (2015 Edition) recommend teniposide as one of
the optional chemotherapy drugs for high-grade gliomas and recurrent low-grade gliomas.
Teniposide brings new treatment options for patients with brain metastases from a variety of malignancies
Due to its pharmacological characteristics such as good ability to penetrate the blood-brain barrier and small molecular weight, teniposide is not only effective in the field of glioma, but also shows good efficacy
in the treatment of other malignant tumors and brain metastases.
Professor Guo said, "The efficacy of the combination chemotherapy regimen of teniposide and carboplatin in the treatment of small cell lung cancer (SCLC) has been confirmed, and this regimen can reduce the incidence of brain metastasis to a certain extent [4].
Regarding the efficacy of teniposide monotherapy in the treatment of brain metastasis, targeted studies have been conducted, and the results show that teniposide monotherapy is active for SCLC brain metastasis [5], and teniposide combined with whole-brain radiotherapy (WBRT) is more effective than teniposide alone in the treatment of SCLC brain metastasis [6].
Teniposide-containing regimens can also bring certain survival benefits
to patients in the treatment of childhood neuroblastoma and germ cell tumor.
In addition, teniposide can also trigger tumor immunogenicity, which has a synergistic effect
with immunotherapies such as programmed death receptor (PD-1) inhibitors.
"
The treatment of neurological malignancies is still very difficult, and there are fewer treatment drugs recommended by the guidelines, and it is expected that teniposide will fully exploit its advantages after returning and continue to improve, bringing longer survival benefits
to this group of patients.
"
A variety of treatment modalities develop together and organically combine to bring better clinical benefits to patients
In the discussion session, Professor Liu Yanhui from West China Hospital of Sichuan University, Professor Wang Yang from Huashan Hospital affiliated to Fudan University, Professor Fan Cungang from Peking University People's Hospital, Professor Mo Ligen from Guangxi Medical University Cancer Hospital, and Professor Yang Haifeng from Chongqing University Cancer Hospital expressed their views
on the diagnosis and treatment of neurological malignant tumors.
Professor Liu Yanhui believes that the treatment of glioma should be a combination
of "standardization", "standardization" and "personalization".
Especially for the treatment of the first diagnosis such as surgery, standard and standardized individualized treatment can lay a good foundation for subsequent treatment, and unified molecular pathological detection standards will provide a strong reference
for subsequent diagnosis.
Fig.
3.
Professor Liu Yanhui Speech
Professor Wang Yang is very experienced in chemoradiotherapy and electric field therapy for glioma, he pointed out that adjuvant electric field therapy with concurrent chemoradiotherapy can bring good efficacy to glioma patients, and it is well tolerated, which is one of the
best choices for glioma patients 。 At the same time, Professor Wang Yang said that the clinical use of teniposide has been very experienced, "return to the west", this return of teniposide will bring more survival benefits to glioma patients, especially patients
with neurological malignant tumors with brain metastases.
Figure 4.
Professor Wang Yang's speech
in the discussion session Professor Fan Cungang affirmed the importance of surgery, radiotherapy, chemotherapy and electric field therapy in glioma patients, and said that temozolomide has become a widely used drug for the treatment of glioma, but at the same time, he is also very optimistic about the prospects of teniposide in the treatment of glioma patients.
It is also proposed that attention can also be raised to whether these treatments can benefit
high-grade gliomas of the spinal cord and peripheral nervous system malignancies with a lower incidence.
Figure 5.
Professor Mo Ligen, a speaker at the discussion session of Professor Fan Cungang, said that he expects electric field therapy to be included in medical insurance as soon as possible, improve accessibility, and bring clear clinical benefits to glioma patients
。 In addition, Professor Morligan mentioned that teniposide has shown good efficacy in the treatment of brain glioma and brain metastases of various malignant tumors, and looks forward to continuing to carry out large-scale phase III.
clinical studies of teniposide combination therapy to provide more evidence-based medical evidence for clinical practice
.
Figure 6.
Professor Moligen's discussion
session Professor Yang Haifeng mainly made suggestions on the application of teniposide in the treatment of glioma patients, he said that when using teniposide in the clinic, in addition to traditional intravenous drugs, intra-arterial chemotherapy can also be carried out in combination with the department.
That is, according to the location of the patient's tumor, teniposide chemotherapy in different arteries may be given better efficacy
.
Figure 7.
Professor Mou Yongjie, who spoke at the discussion session of Professor Yang Haifeng, concluded: "The treatment of glioma patients is a major clinical problem and requires standardized and multidisciplinary diagnosis and treatment.
The return of podophyllotoxin chemotherapy drug teniposide will continue to benefit glioma patients, and its strong blood-brain barrier penetration ability can also bring new treatment options
for patients with other malignant tumors of the brain such as primary central nervous system lymphoma and brain metastases.
In addition, combination regimens such as teniposide with other chemotherapy drugs, immunity and electric field therapy are expected to benefit more patients
.
”
References:
[1] Clark PI，Slevin ML.
The clinical pharmacology of etoposide and teniposide.
Clin Pharmacokinet.
1987 Apr; 12(4):223-52.
[2] Zhao W,Cong Y,Li HM,et al.
Challenges and potential for improving the druggability of podophyllotoxin-derived drugs in cancer chemotherapy.
Nat Prod Rep.
2021 Mar 1; 38(3):470-488.
[3] LI Yan, SHI Rui, CHEN Jianxin, LI Shan, KANG Xun, CHEN Jing, ZHAO Kaihong, LI Wenbin.
Treatment experience of VM-26 and DDP combined with chemotherapy for recurrent high-grade glioma[J].
Journal of Capital Medical University,2015,36(05):786-790.
)
[4] CHEN Qingqing, et al.
Drug Clinical Observation.
2015;(7):788-791.
[5] Postmus PE,et al.
J Clin Oncol.
1995 Mar; 13(3):660-5.
[6] Postmus PE,et al.
Journal of Clinical Oncology 2000; 18(19):3400–8.
*This article is only used to provide scientific information to medical professionals and does not represent the views of this platform
