alexa Sirolimus and Hydroxychloroquine as an Add-On to Standard Therapy for Glioblastoma Multiforme: Case Report | OMICS International
ISSN: 2167-7956

Journal of Biomolecular Research & Therapeutics
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Case Report

Sirolimus and Hydroxychloroquine as an Add-On to Standard Therapy for Glioblastoma Multiforme: Case Report

Mau-Shin Chi1,3, Hui-Ling Ko1, Cheng-Yen Lee1, Kai-Lin Yang1, Ming-Da Tsai2, Kuang-Wen Liao3, Ho-Chi Hsu2* and Kwan-Hwa Chi4,5*

1Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

2Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan

3Institue of Molecular Medicine and Bioengineering, National Chiao-Tung University, Hsinchu, Taiwan

4School of Medicine and Institute of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan

5Institute of Veterinary Clinical Science, School of Veterinary Medicine, National Taiwan University, Taiwan

*Corresponding Authors:
Kwan-Hwa Chi, MD
Department of Radiation Therapy and Oncology
Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
Tel: +886- 2-2838-9327
Fax: +886-2-2837-7582
E-mail: [email protected]
Ho-Chi Hsu, MD
Department of Surgery, Shin Kong Wu Ho-Su Memorial Hospital
Taipei, Taiwan
Tel: +886-2-2838-9327
Fax: +886-2-2837-7582
E-mail: [email protected]

Received date: March 24, 2016; Accepted date: May 12, 2016; Published date: May 19, 2016

Citation:Chi MS, Ko HL, Lee CY, Yang KL, Tsai MD, et al. (2016) Sirolimus and Hydroxychloroquine as an Add-On to Standard Therapy for Glioblastoma Multiforme:Case Report. J Biomol Res Ther 5:141. doi:10.4172/2167-7956.1000141

Copyright: © 2016 Chi MS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Background: Combined surgery, adjuvant radiotherapy (RT) and temozolomide (TMZ) remain the standard treatment for glioblastoma multiforme (GBM). However, the outcome is grave and novel therapeutic targets are actively researched in translational studies. Double modulation of autophagy by simultaneous administration of the inducer, sirolimus, and the inhibitor, hydroxychloroquine (HCQ) has been applied in clinics and reported to be synergistic as an “autophagy paradox”. We describe the first add-on of sirolimus-HCQ to GBM treatment.

Patients and methods: We retrospectively enrolled 20 GBM patients who received surgery followed by nonpalliative TMZ and RT therapy in our institute between January 2007 and April 2014. Of these, 3 patients were treated daily with adjunctive HCQ (400 mg) and sirolimus (2 mg) in addition to the standard TMZ-RT treatment.

Results: The median survival time of the 20 patients was 13.7 months (range: 2.2 to 37 months). Surprisingly, the 3 patients who received sirolimus and HCQ as an add-on treatment survived for a longer period of time (median 34 months). Transient grade 3 myelotoxicity and grade 2 fatigues were rapidly resolved by treatment interruption or dose reduction.

Conclusion: “Autophagy paradox” might be advantageous in combination with standard TMZ-RT treatment for newly diagnosed GBM patients.

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