Nimotuzumab in combination with chemotherapy for patients with malignant gliomas

Objective Nimotuzumab is a humanized monoclonal antibody targeted against epidermal growth factor receptor （EGFR）. Recent clinical studies show that patients with malignant gliomas could benefit from nimotuzumab treatment. The aim of the present study was to evaluate the efficacy and side effects of nimotuzumab in combination with chemotherapy for patients with malignant gliomas. Methods The patients received 200 mg of nimotuzumab infusion intravenously over 60 minutes once weekly for the first eight weeks and then once every two weeks until unacceptable toxicity or tumor progression occurred. Individualized chemotherapy was administered based on O^6-methylguanine-DNA methyhransferase （MGMT） expression and previous chemotherapy responses in combined with nimotuzumab. Results Fourteen patients received a total of 122 times of nimotuzumab ranging from 2 to 20 （ median 7. 5 times ）. Combined chemotherapy regimens included ： continuous 21 -day temozolomide （ 10 cases） , standard 5-day temozolomide （2 cases）, teniposide plus cisplatin （ 1 case）, and teniposide plus nimustine （ 1 case）. Partial response （PR） and stable disease （SD） were found in 3 patients （21.4%）and 6 patients （42. 9% ）, respectively. Disease control rate （PR ＋ SD） was 64.3%. The median progression-free survival （PFS） was 4 months （95% CI：0. 7-7.3 ） and PFS at 6 months was 30.6%. The most common toxicities include grade Ⅰ -Ⅱ neutropenia （2 cases）, thrombocytopenia （ 2 cases）, lymphopenia （ 1 case）, nausea and vomitting （ 3 case） and asymptomatic transaminase increase （1 case）. One patient developed grade Ⅳ neutropenia and thrombocytopenia. One patient developed nimotuzumab-related acneiform rash. Conclusions Nimotuzumab in combination with chemotherapy has moderate activity in patients with malignant gliomas and the toxicities are well tolerable, therefore, worth further investigation. Key words: Gliomas;  Nimotuzumab;  Epidermal growth factor receptor;  Drug therapy