Carboplatin Plus Vincristine as an Alternative Chemotherapeutic Scheme in Patients With Glioblastoma

Marcos V Sangrador-Deitos; Eliezer Villanueva-Castro; Ricardo Marian-Magaña; Luis A Rodríguez-Hernández; Gerardo Y Guinto-Nishimura; Juan L Gómez-Amador; Teresa Corona-Vázquez; Talia Wegman-Ostorozky; Sonia Mejia

doi:10.7759/cureus.24467

Carboplatin Plus Vincristine as an Alternative Chemotherapeutic Scheme in Patients With Glioblastoma

Cureus. 2022 Apr 25;14(4):e24467. doi: 10.7759/cureus.24467. eCollection 2022 Apr.

Authors

Marcos V Sangrador-Deitos¹, Eliezer Villanueva-Castro¹, Ricardo Marian-Magaña¹, Luis A Rodríguez-Hernández¹, Gerardo Y Guinto-Nishimura¹, Juan L Gómez-Amador¹, Teresa Corona-Vázquez², Talia Wegman-Ostorozky³, Sonia Mejia¹

Affiliations

¹ Department of Neurosurgery, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
² Department of Neurology, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, MEX.
³ Department of Genetics, Instituto Nacional de Cancerología, Mexico City, MEX.

Abstract

Background and objective Alternative chemotherapy regimens, including cisplatin, carmustine, or other agents, have been shown to be effective; however, the use of carboplatin plus vincristine (C/V) has not been studied before. In this study, we aimed to determine the survival rates in patients treated with C/V, by comparing our findings with treatments based on temozolomide (TMZ), and to explore a possible relationship with the methylation status of the methylguanine methyltransferase (MGMT) promoter in patients with glioblastoma (GB). Methods A retrospective cohort study was conducted involving 45 surgically treated patients diagnosed with GB. Fresh tissue samples were examined by the DNA bisulfite conversion method to determine methylation status. After surgery, different chemotherapy regimens were employed as adjuvants. Follow-up of participants was performed as outpatients at three-month intervals to determine overall survival (OS), by comparing the use of TMZ versus C/V. Results MGMT promoter methylation status could only be determined in 35 samples; 20 patients received adjuvant chemotherapy, of which 14 were treated with C/V and six with TMZ-based schemes. The median OS (mOS) was eight months (range: 1-24 months). OS was 57.25% at six months, 48.7% at 12 months, and 28.5% at 24 months. In the TMZ group, an OS of 83% was observed at 24 months. In the C/V group, OS was 71.4% at six months, 57.1% at 12 months, and 35.7% at 24 months. Patients who did not receive adjuvant chemotherapy treatment had the lowest survival rates with an OS of 39.9% at six months, 26.6% at 12 months, and 19.9% at 24 months. Conclusions Based on our findings, C/V offers an accessible and effective alternative treatment when the TMZ-based scheme is not accessible, providing higher rates of OS compared to patients without chemotherapy management. The methylation status of the MGMT promoter is a significant prognostic factor, resulting in higher survival rates among patients when it is methylated.

Keywords: carboplatin; chemotherapy; glioblastoma; radiotherapy; vincristine.