The Efficacy and Safety of Adjuvant Lomustine to Chemotherapy for Recurrent Glioblastoma: A Meta-analysis of Randomized Controlled Studies.

INTRODUCTION: Lomustine is regarded as 1 common anti-vascular endothelial growth factor agent. The efficacy of adjuvant lomustine to chemotherapy remains controversial for recurrent glioblastoma. We conduct this meta-analysis to explore the influence of adjuvant lomustine on treatment efficacy of recurrent glioblastoma. METHODS: We have searched PubMed, EMBASE, Web of Science, EBSCO, and Cochrane library databases through August 2019 and included randomized controlled trials assessing the efficacy and safety of adjuvant lomustine for recurrent glioblastoma. RESULTS: Four randomized controlled trials are included in the meta-analysis. Overall, compared with the control group for recurrent glioblastoma, adjuvant lomustine has no substantial effect on objective response (risk ratio [RR], 1.32; 95% confidence interval [CI], 0.91 to 1.93; P = 0.15), complete response (RR, 1.76; 95% CI, 0.26-11.90; P = 0.56), progressive response (RR, 1.32; 95% CI, 0.88-1.99; P = 0.18), median progression-free survival (standard mean difference [SMD], 0.73; 95% CI, -0.65 to 2.11; P = 0.30), or median overall survival (SMD, 0.26; 95% CI, -0.30-0.83; P = 0.36), but results in the increase in 6-month progression-free survival (SMD, 1.71; 95% CI, 0.38-3.04; P = 0.01). There is no increase in grade ≥3 adverse events after adjuvant lomustine treatment (RR, 1.55; 95% CI, 0.84-2.89; P = 0.16) compared with control intervention. CONCLUSIONS: Adjuvant lomustine to other chemotherapy may provide no obvious benefits for the treatment of recurrent glioblastoma.

Upregulation of CPNE3 suppresses invasion, migration and proliferation of glioblastoma cells through FAK pathway inactivation.

Glioblastoma (GBM) is a deadly brain tumor with a bleak prognosis. In recent years, the copine III (CPNE3) protein was discovered to be associated to metastasis across various types of malignancies. Nevertheless, its function has not been well documented in glioma. This study characterizes CPNE3 expression in GBM along with its impact and underlying molecular mechanism with regards to cellular migration, invasion and proliferation. Immunohistochemistry was used to characterizes CPNE3 expression in the glioma tissues. Then, knockdown of CPNE3 expression was used to analyze the role of CPNE3 in GBM cell viability, migration, invasion. Western blot analysis was performed to measure the protein levels of FAK signaling pathway. We found that GBM tissues had higher CPNE3 expressions as compared to those in normal brain tissues. CPNE3 silencing in GBM cells impaired the migratory, invasive and proliferative abilities of GBM cells that can be attributed to inactivation of the FAK signaling pathway. Collectively, these findings highlight the role of CPNE3 as a new biomarker, offering deeper insights into its carcinogenic role in GBM.

The efficacy and safety of radiotherapy with adjuvant temozolomide for glioblastoma: A meta-analysis of randomized controlled studies.

The efficacy of radiotherapy with adjuvant temozolomide for glioblastoma remains controversial. We conduct a systematic review and meta-analysis to explore the influence of radiotherapy with adjuvant temozolomide on treatment efficacy for glioblastoma.We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through November 24, 2019 for randomized controlled trials (RCTs) assessing the efficacy and safety of adjuvant temozolomide to radiotherapy for glioblastoma. This meta-analysis is performed using the random-effect model.Five RCTs are included in the meta-analysis. Overall, compared with radiotherapy for glioblastoma, adjuvant temozolomide is associated with substantially improved overall survival (HR = 0.63; 95% CI = 0.52-76; P < 0.00001) and 2-year survival rate (3.25 = 1.76; 95% CI = 2.13-4.94; P < 0.00001), with no increase in adverse events (RR = 0.76; 95% CI = 0.40-1.45; P = 0.41). However, adjuvant temozolomide appears to increase the incidence of haematological complications than only radiotherapy (RR = 3.58; 95% CI = 1.10-11.59; P = 0.03).Adjuvant temozolomide to radiotherapy may provide better efficacy for the treatment of glioblastoma.