Abstract
Over the past decade a series of trials of the EORTC Brain Tumor Group (BTG) has substantially influenced and shaped the standard-of-care of primary brain tumors. All these trials were coupled with biological research that has allowed for better understanding of the biology of these tumors. In glioblastoma, EORTC trial 26981/22981 conducted jointly with the National Cancer Institute of Canada Clinical Trials Group showed superiority of concomitant radiochemotherapy with temozolomide over radiotherapy alone. It also identified the first predictive marker for benefit from alkylating agent chemotherapy in glioblastoma, the methylation of the O6-methyl-guanyl-methly-transferase (MGMT) gene promoter. In another large randomized trial, EORTC 26951, adjuvant chemotherapy in anaplastic oligodendroglial tumors was investigated. Despite an improvement in progression-free survival this did not translate into a survival benefit. The third example of a landmark trial is the EORTC 22845 trial. This trial led by the EORTC Radiation Oncology Group forms the basis for an expectative approach to patients with low-grade glioma, as early radiotherapy indeed prolongs time to tumor progression but with no benefit in overall survival. This trial is the key reference in deciding at what time in their disease adult patients with low-grade glioma should be irradiated.Future initiatives will continue to focus on the conduct of controlled trials, rational academic drug development as well as systematic evaluation of tumor tissue including biomarker development for personalized therapy. Important lessons learned in neurooncology are to dare to ask real questions rather than merely rapidly testing new compounds, and the value of well designed trials, including the presence of controls, central pathology review, strict radiology protocols and biobanking. Structurally, the EORTC BTG has evolved into a multidisciplinary group with strong transatlantic alliances. It has contributed to the maturation of neurooncology within the oncological sciences.
| Original language | English |
|---|---|
| Pages (from-to) | 20-26 |
| Number of pages | 7 |
| Journal | European Journal of Cancer, Supplement |
| Volume | 10 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Mar 2012 |
Bibliographical note
Funding Information:Denis Lacombe, Thierry Gorlia, Anouk Allgeier, Max Kros, Charles Vecht, and ABMF Karim declare no conflicts of interest. Riccardo Soffietti consulted for MSD, Merck-Serono, Mundipharma, and consulted for and received research funds from Roche. Monika Hegi consulted for MDxHealth and MDS, and consulted for and received honoraria from Merck-Serono. Roger Stupp consulted (advisory boards) for Merck Serono, MSD/Merck & Co (formerly Schering-Plough), MDx Health, and Roche Pharma. Alba Brandes was a member of advisory boards for and received honoraria from Roche and Schering-Plough, and received honoraria from GSK. Marc Sanson consulted for and received honoraria from Merck and Roche, and received research funds from Pfizer. Martin Taphoorn received research funds from the Dutch Cancer Society, EORTC Quality of Life Group, and Jacobus Foundation The Hague. Wolfgang Wick consulted for and received honoraria and research funds from MSD, consulted for and received honoraria from Roche, consulted for Noxxon and Antisense Pharma, and received research funds from Eli Lilly and Apogenix. Martin van den Bent consulted for and received honoraria from MSD. Réne-Olivier Mirimanoff consulted for and received honoraria and research funds from MDS and Schering-Plough. Brigitta G. Baumert consulted and received honoraria and research funds from MSD and Schering-Plough, and consulted for and received honoraria from the Institute for Quality and Efficiency in Health Care.
