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Topoisomerase 1 inhibitors may have activity in malignant gliomas

Recently presented data from Duke University, North Carolina suggests that topoisomerase 1 inhibitors (specifically topotecan, irinotecan and 9-amino-camtothecin) have activity in in vitro glioma and medulloblastoma cell lines. Further, in a clinical trial of 60 patients who had received no more than 1 previous form of chemotherapy, there were 9 partial responders, 4 minimal responders and 13 disease stabilisation results, with 34 patients progressing despite therapy. As second line therapy in this relatively chemo-resistant disease, these results are of interest. The clinicians are now combining these drugs with standards first line therapies such as carmustine or temozolamide to try to enhance first line response rates.