Brain Tumours

Relapsed GBM after RT-TMZ

• No established standard

– re-resection +/- carmustine wafers? – PCV? – various studies of chemo + bevacizumab • High response rates but no clear survival benefit

– cediranib (VEGFR inhibitor) +/- CCNU: • no benefit

– other studies of EGFR TK inhibitors • erlotinib associated with reduced PFS (van den Bent JCO 2009) – TMZ rechallenge +/- altered temozolomide scheduling?

Opportunity to test novel agents