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fotemustine

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Description

Fotemustine is an alkylating antineoplastic agent. It is a nitrogen mustard derivative that is used to treat malignant brain tumors, such as glioblastoma multiforme. Fotemustine is a lipophilic drug that can cross the blood-brain barrier, allowing it to reach the brain and central nervous system. It is administered intravenously and its mechanism of action involves the alkylation of DNA, which inhibits DNA replication and cell division. The synthesis of fotemustine involves the reaction of a nitrogen mustard with a cyclophosphamide derivative. Fotemustine is studied because it is a promising treatment option for malignant brain tumors, which are often resistant to conventional chemotherapy. Research is ongoing to investigate its efficacy, safety, and optimal dosing. Clinical trials are evaluating the use of fotemustine in combination with other chemotherapeutic agents, as well as its potential role in the treatment of other types of cancer.'

fotemustine: structure given in first source [Medical Subject Headings (MeSH), National Library of Medicine, extracted Dec-2023]

fotemustine : A racemate comprising equimolar amounts of (R)- and (S)-fotemustine. It is an alkylating agent used in the treatment of malignant melanoma. [Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

diethyl (1-{[(2-chloroethyl)(nitroso)carbamoyl]amino}ethyl)phosphonate : A member of the class of N-nitrosoureas that is ethyl diethylphosphonate in the hydrogen at position 1 of the ethyl group attached to the phosphorus has been replaced by a [(2-chloroethyl)(nitroso)carbamoyl]amino group. [Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Cross-References

ID SourceID
PubMed CID104799
CHEMBL ID549386
CHEBI ID131852
SCHEMBL ID8880
MeSH IDM0153576

Synonyms (69)

Synonym
servier-10036
s-10036
fotemustine
muphoran
fotemustinum [latin]
phosphonic acid, (1-((((2-chloroethyl)nitrosoamino)carbonyl)amino)ethyl)-, diethyl ester
s 10036
ccris 6337
fotemustina [spanish]
c9h19cln3o5p
fotemustine (inn/ban)
muphoran (tn)
D07255
92118-27-9
diethyl-1-(3-(2-chloroethyl)-3-nitrosoureido)ethylphosphonate
(+-)-diethyl (1-(3-(2-chloroethyl)-3-nitrosoureido)ethyl)phosphonate
mustoforan
s10036 ,
mustophorane
CHEMBL549386
diethyl (1-{[(2-chloroethyl)(nitroso)carbamoyl]amino}ethyl)phosphonate
CHEBI:131852
1-(2-chloroethyl)-3-(1-diethoxyphosphorylethyl)-1-nitrosourea
1-(2-chloroethyl)-3-(1-diethoxyphosphorylethyl)-1-nitroso-urea
A844148
AKOS015920275
unii-gq7jl9p5i2
fotemustina
hsdb 7762
fotemustinum
gq7jl9p5i2 ,
fotemustine [inn:ban]
FT-0630979
NCGC00346829-01
fotemustine [inn]
fotemustine [mi]
fotemustine [who-dd]
phosphonic acid, p-(1-((((2-chloroethyl)nitrosoamino)carbonyl)amino)ethyl)-, diethyl ester
fotemustine [mart.]
(+/-)-diethyl (1-(3-(2-chloroethyl)-3-nitrosoureido)ethyl)phosphonate
fotemustine [hsdb]
diethyl (1-(3-(2-chloroethyl)-3-nitrosoureido)ethyl)phosphonate
HY-B0733
MLS006010716
smr002529685
MLS006010211
SCHEMBL8880
DS-1395
diethyl (1-{[n-(2-chloroethyl)-n'-oxohydrazinecarbonyl]amino}ethyl)phosphonate
sr-01000944936
SR-01000944936-1
fotemustine, >=98% (hplc)
diethyl 1-(3-(2-chloroethyl)-3-nitrosoureido)ethylphosphonate
BCP07342
Q1439555
6-amino-3-hydroxy(1h)indazole
DTXSID80869091
unii-qy93p3gn94
unii-upb2nn83ar
NCGC00346829-03
phosphonic acid, (1-((((2-chloroethyl)nitrosoamino)carbonyl)amino)ethyl)-, diethyl ester, (-)-
QY93P3GN94 ,
191219-77-9
phosphonic acid, (1-((((2-chloroethyl)nitrosoamino)carbonyl)amino)ethyl)-, diethyl ester, (+)-
fotemustine, (-)-
fotemustine, (+)-
191220-84-5
UPB2NN83AR ,
fotemustene

Research Excerpts

Overview

Fotemustine (FTM) is a common treatment option for glioblastoma patients refractory to temozolomide (TMZ) It is a third-generation nitrosourea showing efficacy in various types of tumors such as melanoma and glioma.

ExcerptReferenceRelevance
"Fotemustine (FTM) is a common treatment option for glioblastoma patients refractory to temozolomide (TMZ). "( Efficacy and safety of second-line fotemustine in elderly patients with recurrent glioblastoma.
Berardi, R; Burattini, L; Cascinu, S; Detti, B; Fabrini, MG; Iacovelli, R; Lolli, I; Perrone, F; Santoni, M; Savio, G; Scoccianti, S; Silvano, G, 2013
)
2.11
"Fotemustine is a third-generation nitrosourea showing efficacy in various types of tumors such as melanoma and glioma. "( An overview of fotemustine in high-grade gliomas: from single agent to association with bevacizumab.
Bellu, L; Cecchin, D; Della Puppa, A; Farina, P; Lombardi, G; Pambuku, A; Zagonel, V, 2014
)
2.2
"Fotemustine (FTM) is a third-generation nitrosourea showing efficacy in gliomas and it has been used with different schedules in adult patients."( Clinical outcome of an alternative fotemustine schedule in elderly patients with recurrent glioblastoma: a mono-institutional retrospective study.
Bellu, L; D'Avella, D; Della Puppa, A; Farina, M; Fiduccia, P; Lombardi, G; Pambuku, A; Zagonel, V, 2016
)
1.43
"Fotemustine is a nitrosourea compound used for the treatment of malignant gliomas, especially in France. "( Concurrent radiotherapy: fotemustine combination for newly diagnosed malignant glioma patients, a phase II study.
Beauchesne, PD; Bernier, V; Carnin, C; Taillandier, L, 2009
)
2.1
"Fotemustine is a cancer chemotherapeutic agent that belongs to an extremely active class of alkylating compounds."( Antimutagenicity of amifostine against the anticancer drug fotemustine in the Drosophila somatic mutation and recombination (SMART) test.
Aydemir, N; Bilaloglu, R; Celikler, S; Sevim, N; Vatan, O,
)
1.1
"Fotemustine (FTMS) is a third-generation nitrosourea, in preclinical studies, FTMS compared favorably with carmustine (BCNU) and lomustine (CCNU) against several human tumor cell lines. "( Lecture: fotemustine in brain tumors.
Botturi, A; Ferrari, D; Gaviani, P; Lamperti, E; Salmaggi, A; Silvani, A; Simonetti, G, 2011
)
2.23
"Fotemustine is a nitrosurea that has proved its efficacy in metastatic melanoma and particularly on cerebral metastases, given its high lipophilicity, facilitating its active penetration in all tissues including the central nervous system. "( Fotemustine for the treatment of melanoma.
Dréno, B; Quéreux, G, 2011
)
3.25
"Fotemustine is a chemotherapy drug usually administered intravenously according to standard administration schedules."( Initial experience with hepatic intraarterial fotemustine and interferon alpha 2b combination for treatment of liver tumors.
Arcoria, D; Calì, S; DI Maggio, EM; Ferraù, F; Malaponte, E; Panebianco, V; Parisi, A; Romeo, P; Vasta, F; Vitale, FV, 2011
)
1.35
"Fotemustine is an alkylating cytostatic drug belonging to the nitrosourea family and is used in particular in the treatment of disseminated malignant melanoma. "( [New toxicity of fotemustine: diffuse interstitial lung disease].
Auffret, M; Bertrand, M; Gauthier, S; Mortier, L; Wémeau-Stervinou, L, 2012
)
2.16
"Fotemustine is a nitrosourea with theoretic and preclinical advantages over the original analogs, carmustine and lomustine, in the treatment of brain tumors. "( Phase I study of fotemustine in pediatric patients with refractory brain tumors.
Baruchel, S; Bouffet, E; Gammon, J; Grant, RM; Hargrave, DR; Tariq, N, 2002
)
2.1
"Fotemustine is a third generation chloroethylnitrosourea that has demonstrated significant antitumoral effects in malignant melanoma. "( Cytotoxicity, DNA damage, and apoptosis induced by new fotemustine analogs on human melanoma cells in relation to O6-methylguanine DNA-methyltransferase expression.
Cupissol, D; Cuq, P; Depeille, P; Evrard, A; Montero, JL; Passagne, I; Vian, L; Winum, JY, 2003
)
2.01
"Fotemustine is a cytotoxic drug belonging to the group of nitrosourea derivatives, and is used in the treatment of metastatic melanoma, particularly when secondary brain lesions are present. "( Neurological toxicity during metastatic melanoma treatment with fotemustine.
Carlander, B; Guillot, B; Khalil, Z; Pageot, N, 2005
)
2.01
"Fotemustine is a DNA-alkylating drug while vinorelbine is a semi-synthetic Vinca alkaloid."( Genotoxic effects induced by fotemustine and vinorelbine in human lymphocytes.
Aydemir, N; Bilaloğlu, R; Celikler, S,
)
1.14
"Fotemustine is a cytotoxic alkylating agent, belonging to the group of nitrosourea family. "( Focus on Fotemustine.
Aquino, A; Bonmassar, E; De Rossi, A; De Vecchis, L; Laudisi, A; Leti, M; Marchesi, F; Rossi, L; Sini, V; Toppo, L; Torino, F; Tortorelli, G; Turriziani, M, 2006
)
2.19
"Fotemustine (FM) is a new chloronitrosurea (CNU), chemically characterized by the graft of an aminophosphonic acid on the CNU radical, which makes it highly lipophilic. "( Palliative therapy of melanoma patients with fotemustine. Inverse relationship between tumour load and treatment effectiveness. A multicentre phase II trial of the EORTC-Melanoma Cooperative Group (MCG).
Bröcker, EB; Engel, E; Gérard, B; Glabbeke, MV; Israels, P; Kennes, C; Kleeberg, UR; Lejeune, F; Lentz, MA; Tilgen, W, 1995
)
1.99
"Fotemustine (Fote) is a new aminoacid linked chloroethyl nitrosourea which has been shown to be useful in disseminated malignant melanoma. "( [Tamoxifen increases cytotoxic effects of fotemustine. Experimental results on cell lines of human melanoma].
Barbé, V; Berlion, M; Berrile, J; Bizzari, JP; Fischel, JL; Formento, P; Milano, G, 1994
)
2
"Fotemustine is a novel chloroethylnitrosourea, that readily penetrates the blood brain barrier. "( Phase II trial of fotemustine in patients with metastatic malignant melanoma.
Falkson, CI; Falkson, G; Falkson, HC, 1994
)
2.07
"Fotemustine is a new chloroethylnitrosourea characterized by the grafting of a phosphonoalanine group onto a nitrosourea radical. "( Fotemustine in the treatment of brain primary tumors and metastases.
Berille, J; Bertrand, P; Bizzari, JP; Cour, V; Gerard, B; Giroux, B; Khayat, D; Sarkany, M, 1994
)
3.17
"Fotemustine is a chemotherapeutic drug for the treatment of melanoma. "( Chemical and glutathione conjugation-related degradation of fotemustine: formation and characterization of a glutathione conjugate of diethyl (1-isocyanatoethyl)phosphonate, a reactive metabolite of fotemustine.
Brakenhoff, JP; Commandeur, JN; de Kanter, FJ; Luijten, WC; van Baar, BL; Vermeulen, NP,
)
1.82
"Fotemustine is a new nitrosourea derivative whose activity has been demonstrated on metastatic melanoma with specific activity on brain metastases and also on poor prognosis lung cancers. "( Cisplatin-fotemustine combination in inoperable non-small cell lung cancer: preliminary report of a French multicentre phase II trial.
Baio, S; Berille, J; Le Cesne, A; Le Chevalier, T; Rivière, A, 1994
)
2.13
"Fotemustine (Fote) is a new amino acid-linked chloroethyl nitrosourea which has been shown to be useful in disseminated malignant melanoma. "( Tamoxifen enhances the cytotoxic effects of the nitrosourea fotemustine. Results on human melanoma cell lines.
Barbé, V; Berlion, M; Berrile, J; Bizzari, JP; Fischel, JL; Formento, P; Milano, G, 1993
)
1.97
"Fotemustine is a clinically used DNA-alkylating 2-chloro-ethyl-substituted N-nitrosourea, which sometimes shows signs of haematotoxicity and reversible liver and renal toxicity as toxic side-effects. "( Molecular mechanisms of toxic effects of fotemustine in rat hepatocytes and subcellular rat liver fractions.
Brakenhoff, JP; Commandeur, JN; Groot, EJ; Vermeulen, NP; Wormhoudt, LW, 1996
)
2
"Fotemustine is a chloroethylnitrosourea with antitumor activity in disseminated melanoma and adult primary brain tumors. "( Activity of fotemustine in medulloblastoma and malignant glioma xenografts in relation to O6-alkylguanine-DNA alkyltransferase and alkylpurine-DNA N-glycosylase activity.
Boland, I; Gouyette, A; Lacroix, C; Lellouch-Tubiana, A; Margison, GP; Morizet, J; Parker, F; Pierre-Kahn, A; Poullain, MG; Terrier-Lacombe, MJ; Vassal, G; Vénuat, AM; Watson, AJ, 1998
)
2.12
"Fotemustine is a relatively novel DNA-alkylating 2-chloroethyl-substituted N-nitrosourea (CENU) drug, clinically used for the treatment of disseminated malignant melanoma in different visceral and non-visceral tissues. "( Toxicity of fotemustine in rat hepatocytes and mechanism-based protection against it.
Brakenhoff, JP; Commandeur, JN; Groot, EJ; Li, QJ; Ramnatshing, S; Vermeulen, NP; Wormhoudt, LW, 1998
)
2.12
"Fotemustine is a third-generation nitrosourea characterized by a phosphoalanine carrier group grafted onto the nitrosourea radical, which gives it a high lipophilicity and a better penetration through the cell membrane. "( [Fotemustine (Muphoran) in 22 patients with relapses of high-grade cerebral gliomas].
Dam-Hieu, P; Labat, JP; Lucas, B; Malhaire, JP; Person, H; Simon, H, 1999
)
2.66
"Fotemustine is a new nitrosourea which is active against disseminated malignant melanoma. "( [Contribution of a new nitrosourea compound: fotemustine].
Boaziz, C, 1992
)
1.99
"Fotemustine is a new chloronitrosourea which is active against disseminated malignant melanoma (DMM), and especially against cerebral metastases (CM). "( Fotemustine: an overview of its clinical activity in disseminated malignant melanoma.
Avril, MF; Bertrand, P; Bizzari, JP; Cour, V; Gerard, B; Khayat, D, 1992
)
3.17
"Fotemustine is a new nitrosourea derivative that contains an alpha-aminophosphonic acid and has a short half-life and a high plasma clearance. "( Hepatic intra-arterial infusion of fotemustine: pharmacokinetics.
Cour, V; Fety, R; Lucas, C; Solere, P; Vignoud, J, 1992
)
2
"Fotemustine is a highly reactive chloroethyl-nitrosourea anti-tumor drug that is currently undergoing phase III clinical trials in stage IV metastatic malignant melanoma. "( Local treatment of cutaneous and subcutaneous metastatic malignant melanoma with fotemustine.
Breitbart, EW; Mensing, H; Schallreuter, KU; Wood, JM, 1991
)
1.95
"Fotemustine is a well tolerated active drug in recurrent malignant gliomas with an original and short treatment schedule."( Phase II study of fotemustine in recurrent supratentorial malignant gliomas.
Derlon, JM; Frenay, M; Giroux, B; Khoury, S; Namer, M, 1991
)
1.34
"Fotemustine is a new nitrosourea which has shown some efficacy on disseminated malignant melanoma (DMM) (24.2% response rate (RR) among 153 patients in a Phase II trial) but little activity on hepatic metastasis (8.8% RR). "( Fotemustine (S 10036) in the intra-arterial treatment of liver metastasis from malignant melanoma. A phase II Study.
Aigner, K; Auclerc, G; Bizzari, JP; Borel, C; Bousquet, JC; Buthiau, D; Cohen-Alloro, G; Cour, V; Khayat, D; Weil, M, 1991
)
3.17
"Fotemustine is a novel chloroethylnitrosourea derivative currently used in Phase III clinical trials for disseminated metastatic melanoma. "( Sensitivity and resistance in human metastatic melanoma to the new chloroethylnitrosourea anti-tumor drug Fotemustine.
Schallreuter, KU; Wood, JM, 1991
)
1.94
"Fotemustine is a new chloronitrosourea recently developed by the French company Servier. "( [Fotemustine, a new nitrosourea derivative. Current status of development].
Cour, V; Langenbahn, H, 1990
)
2.63
"Fotemustine (S 10036) is a new anti-tumor nitrosourea characterized by a phosphonoalanine carrier group coupled to the nitrosourea moiety, which potentially increases the cellular penetration of the drug. "( In vitro chemosensitivity testing of Fotemustine (S 10036), a new antitumor nitrosourea.
Bizzari, JP; Deloffre, P; Etienne, MC; Fischel, JL; Formento, P; Frenay, M; Gioanni, J; Milano, G, 1990
)
1.99
"Fotemustine is a new chloroethylnitrosourea which has recently entered a Phase II clinical trial. "( Cytotoxicity and DNA damaging effects of a new nitrosourea, fotemustine, diethyl- 1-(3-(2-chloroethyl)-3-nitrosoureido) ethylphosphonate-S10036.
Bizzari, JP; Catalin, J; Deloffre, P; Paraire, M; Rustum, Y; Tapiero, H; Tew, KD; Yin, MB,
)
1.82
"Fotemustine (S 10036) is a new nitrosourea compound whose antitumoral activity has been demonstrated, particularly in disseminated malignant melanoma. "( [Study of the clinical pharmacokinetics of fotemustine in various tumor indications].
Beerblock, K; Bizzari, JP; Deloffre, P; Lokiec, F; Lucas, C, 1989
)
1.98

Effects

14C Fotemustine has been used to determine its reactivity and metabolism in drug sensitive and resistant melanoma metastases. The drug has shown therapeutic efficacy as single-drug second-line chemotherapy in treatment of TMZ pretreated patients.

ExcerptReferenceRelevance
"Fotemustine has shown therapeutic efficacy as single-drug second-line chemotherapy in treatment of TMZ pretreated patients."( Second-line chemotherapy with fotemustine in temozolomide-pretreated patients with relapsing glioblastoma: a single institution experience.
Ammannati, F; Biti, G; Bordi, L; Borghesi, S; Detti, B; Iannalfi, A; Leonulli, BG; Martinelli, F; Meattini, I; Sardaro, A; Scoccianti, S, 2008
)
1.36
"Fotemustine therefore has no activity in advanced gastric cancer."( Fotemustine in patients with advanced gastric cancer, a phase II trial from the EORTC-GITCCG (European Organization for Research and Treatment of Cancer, Gastrointestinal Tract Cancer Cooperative Group).
Bleiberg, H; De Greve, J; Fabri, MC; Gerard, B; Kok, T; Paillot, B; Rougier, P; Van Glabbeke, M; van Pottelsberghe, C; Wagener, T, 1996
)
2.46
"As fotemustine (FOT) has demonstrated activity on cerebral metastases, the rationale of this study was to replace carmustine by FOT in this four-drug regimen."( Combined treatment with dacarbazine, cisplatin, fotemustine and tamoxifen in metastatic malignant melanoma.
Bassères, N; Bizzari, JP; Bonerandi, JJ; Gérard, B; Grob, JJ; Richard, MA; Zarrour, H, 1998
)
1.07
"Fotemustine has also been used in combination with dacarbazine (DTIC), in patients with DMM."( Fotemustine: an overview of its clinical activity in disseminated malignant melanoma.
Avril, MF; Bertrand, P; Bizzari, JP; Cour, V; Gerard, B; Khayat, D, 1992
)
2.45
"Fotemustine has been administered to 10 patients with metastatic or redux soft sarcoma in a phase II pilot study. "( [Fotemustine: a pilot phase II trial in sarcoma of the soft tissues].
Berille, J; Bizzari, JP; Jacquillat, C; Khayat, D; Spielmann, M; Tursz, T, 1991
)
2.63
"14C Fotemustine has been used to determine its reactivity and metabolism in drug sensitive and resistant melanoma metastases and in cultures of sensitive and resistant clones of human melanoma cells."( Sensitivity and resistance in human metastatic melanoma to the new chloroethylnitrosourea anti-tumor drug Fotemustine.
Schallreuter, KU; Wood, JM, 1991
)
0.98

Treatment

HIA treatment with fotemustine did not translate into an improved OS compared with IV treatment. Planned treatment duration was 6 months, starting with four weekly doses of 100 mg/m(2)

ExcerptReferenceRelevance
"fotemustine. Planned treatment duration was 6 months, starting with four weekly doses of 100 mg/m(2), and after a 5-week rest, repeated every 3 weeks."( Adjuvant intra-arterial hepatic fotemustine for high-risk uveal melanoma patients.
Denys, A; Goitein, G; Halkic, N; Leyvraz, S; Pampallona, S; Peters, S; Schalenbourg, A; Voelter, V; Zografos, L, 2008
)
1.35
"With fotemustine-treated plasmid, the fotemustine-resistant subline did not exhibit an increased repair of directly fotemustine-induced DNA damage."( Alterations of DNA repair in melanoma cell lines resistant to cisplatin, fotemustine, or etoposide.
Diem, C; Emmert, S; Epe, B; Hellfritsch, D; Rünger, TM; Schadendorf, D, 2000
)
0.99
"HIA treatment with fotemustine did not translate into an improved OS compared with IV treatment, despite better RR and PFS. "( Hepatic intra-arterial versus intravenous fotemustine in patients with liver metastases from uveal melanoma (EORTC 18021): a multicentric randomized trial.
Baurain, JF; Durando, X; Gurunath, RK; Jouary, T; Kaempgen, E; Keilholz, U; Leyvraz, S; Marshall, E; Negrier, S; Piperno-Neumann, S; Schadendorf, D; Scheulen, M; Suciu, S; Testori, A; Vermorken, JB; Zdzienicki, M, 2014
)
1

Toxicity

ExcerptReferenceRelevance
"Fotemustine is a clinically used DNA-alkylating 2-chloro-ethyl-substituted N-nitrosourea, which sometimes shows signs of haematotoxicity and reversible liver and renal toxicity as toxic side-effects."( Molecular mechanisms of toxic effects of fotemustine in rat hepatocytes and subcellular rat liver fractions.
Brakenhoff, JP; Commandeur, JN; Groot, EJ; Vermeulen, NP; Wormhoudt, LW, 1996
)
2
" This adverse event should be managed with caution."( Nitroso-urea-cisplatin-based chemotherapy associated with valproate: increase of haematologic toxicity.
Bourg, V; Chichmanian, RM; Frenay, M; Lebrun, C; Thomas, P, 2001
)
0.31
" However, its use is somewhat limited by its toxic side effects and chemoresistance caused by direct repair of O6-alkyl groups by the enzyme O6-methylguanine DNA-methyltransferase (MGMT)."( Cytotoxicity, DNA damage, and apoptosis induced by new fotemustine analogs on human melanoma cells in relation to O6-methylguanine DNA-methyltransferase expression.
Cupissol, D; Cuq, P; Depeille, P; Evrard, A; Montero, JL; Passagne, I; Vian, L; Winum, JY, 2003
)
0.57
"This study showed that FTM is a valuable therapeutic option for elderly glioblastoma patients, with a safe toxicity profile."( Efficacy and safety of second-line fotemustine in elderly patients with recurrent glioblastoma.
Berardi, R; Burattini, L; Cascinu, S; Detti, B; Fabrini, MG; Iacovelli, R; Lolli, I; Perrone, F; Santoni, M; Savio, G; Scoccianti, S; Silvano, G, 2013
)
0.67
" Treatment adverse events were mostly mild to moderate in intensity."( Activity and safety of bevacizumab plus fotemustine for recurrent malignant gliomas.
Carapella, CM; Carosi, MA; Cognetti, F; Fabi, A; Giannarelli, D; Marucci, L; Metro, G; Pace, A; Piludu, F; Pompili, A; Telera, S; Vaccaro, V; Vari, S; Vidiri, A; Villani, V, 2014
)
0.67
" Grades 3-4 toxicity was 28 % (31 patients), being neutropenia (4 %) and thrombocytopenia (17 %) the most frequent adverse reactions."( GEINOFOTE: efficacy and safety of fotemustine in patients with high-grade recurrent gliomas and poor performance status.
Benavides, M; Berros, JP; Cano, JM; Ceballos, I; Covela, M; Fernández, I; Fuster, J; García Bueno, JM; García, A; Manneh, R; Moreno, V; Pérez-Segura, P; Quintanar, T; Sepúlveda, J; Vaz, MA, 2016
)
0.71
"This study has shown that FTM is safe and has a comparable activity with other available therapeutic options of use in the treatment of recurrent HGG."( GEINOFOTE: efficacy and safety of fotemustine in patients with high-grade recurrent gliomas and poor performance status.
Benavides, M; Berros, JP; Cano, JM; Ceballos, I; Covela, M; Fernández, I; Fuster, J; García Bueno, JM; García, A; Manneh, R; Moreno, V; Pérez-Segura, P; Quintanar, T; Sepúlveda, J; Vaz, MA, 2016
)
0.71
" We retrieved evidence on treatment-related grade III/IV adverse events, progression-free survival (PFS) and overall survival (OS)."( A systematic literature review and network meta-analysis of effectiveness and safety outcomes in advanced melanoma.
Franken, MG; Gheorghe, M; Haanen, JBAG; Leeneman, B; Uyl-de Groot, CA; van Baal, PHM, 2019
)
0.51

Pharmacokinetics

Fotemustine is a new nitrosourea derivative that contains an alpha-aminophosphonic acid. It has a short half-life and a high plasma clearance. No significant difference was noted in the AUC between days 1, 2 or 3.

ExcerptReferenceRelevance
"Fotemustine is a new nitrosourea derivative that contains an alpha-aminophosphonic acid and has a short half-life and a high plasma clearance."( Hepatic intra-arterial infusion of fotemustine: pharmacokinetics.
Cour, V; Fety, R; Lucas, C; Solere, P; Vignoud, J, 1992
)
2
"8 micrograms/ml, and declined monophasically with a half-life of about 24 min."( Disposition, pharmacokinetics, and metabolism of 14C-fotemustine in cancer patients.
Breen, M; Brownsill, R; Gordon, BH; Gray, AJ; Hiley, M; Ings, RM; Marchant, N; Richards, R; Taylor, AR; Wallace, D, 1990
)
0.53
" Pharmacokinetic parameters of this drug were investigated during phase II clinical trials and compared according to tumor type."( [Study of the clinical pharmacokinetics of fotemustine in various tumor indications].
Beerblock, K; Bizzari, JP; Deloffre, P; Lokiec, F; Lucas, C, 1989
)
0.54
" In all, 40 pharmacokinetic determinations of fotemustine were made at dose levels ranging from 2 x 300 to 2 x 500 mg/m2."( Phase I pharmacokinetics study of high-dose fotemustine and its metabolite 2-chloroethanol in patients with high-grade gliomas.
Biron, P; Evene, E; Giroux, B; Gordon, B; Lucas, C; Mornex, F; Richards, R; Roux, N; Solere, P; Tranchand, B, 1993
)
0.81
" Pharmacokinetic data were assessed during this Phase I-II study and reported here."( Phase I-II and pharmacokinetic study of a new fotemustine schedule in advanced non-small cell lung cancer.
Baud, M; Bérille, J; Chabot, G; Gouyette, A; Le Cesne, A; Le Chevalier, T; Lucas, C; Marty, M, 1995
)
0.55
" No significant difference was noted in the AUC between days 1, 2 or 3 in any of the seven patients in whom a pharmacokinetic study of Fotemustine was performed."( Phase I-II and pharmacokinetic study of a new fotemustine schedule in advanced non-small cell lung cancer.
Baud, M; Bérille, J; Chabot, G; Gouyette, A; Le Cesne, A; Le Chevalier, T; Lucas, C; Marty, M, 1995
)
0.75
"The nitrosourea, fotemustine, was given intravenously in 1 h constant-rate infusion to 66 patients in a multicentric study to assess both fotemustine pharmacokinetic behaviour and the pharmacokinetic-pharmacodynamic relationships."( Pharmacokinetics and pharmacodynamics of nitrosourea fotemustine: a French cancer centre multicentric study.
Fety, R; Iliadis, A; Launay-Iliadis, MC; Lokiec, F; Lucas, C; Milano, G; Tranchand, B, 1996
)
0.88
" The pharmacokinetic parameters in renal-impaired patients were not significantly different from those in patients with normal renal function with a similar incidence of grade 3-4 toxicity in both groups."( Clinical and pharmacokinetic phase II study of fotemustine in refractory and relapsing multiple myeloma patients.
Ardiet, C; Berger, E; Bouafia, F; Coiffier, B; Dumontet, C; Guyotat, D; Jaubert, J; Lucas, C; Sebban, C; Tranchand, B, 2003
)
0.58
" In total, 18 blood samples were collected for pharmacokinetic analysis (maximum plasma concentration, area under the concentration-time curve and total clearance) of D and F at 14 time points during therapy."( Preliminary study on pharmacokinetics of dacarbazine and fotemustine in glioblastoma multiforme patients does not indicate gender-specific differences.
Fazeny-Dörner, B; Mader, RM; Marosi, C; Piribauer, M; Rizovski, B; Stögermaier, B, 2004
)
0.57

Compound-Compound Interactions

Temozolomide combined with fotemustine is an active and moderately safe first-line chemotherapy regimen with acceptable and easily manageable toxicities in patients with metastatic melanoma.

ExcerptReferenceRelevance
"The aims of this phase I study in patients with recurrent malignant gliomas were to determine the maximum tolerated dose (MTD) and toxicity profile of fotemustine when combined with a fixed dose of procarbazine (PCZ), and to evaluate the extent of O6-alkylguanine-DNA alkyltransferase (ATase) depletion in circulating lymphocytes during treatment."( Fotemustine combined with procarbazine in recurrent malignant gliomas: a phase I study with evaluation of lymphocyte 06-alkylguanine-DNA alkyltransferase activity.
Berger, E; Boiardi, A; Ciusani, E; Giroux, B; Lucas, C; Margison, G; Silvani, A; Watson, A, 2001
)
1.95
"The regimen, temozolomide combined with fotemustine, is an active and moderately safe first-line chemotherapy regimen with acceptable and easily manageable toxicities in patients with metastatic melanoma."( Temozolomide in combination with fotemustine in patients with metastatic melanoma.
Camlica, H; Tas, F; Topuz, E, 2008
)
0.89
"To evaluate the efficacy of hypofractionated stereotactic radiotherapy performed as reirradiation in combination with fotemustine or bevacizumab as salvage treatment in patients with recurrent malignant glioma."( Hypofractionated stereotactic radiotherapy in combination with bevacizumab or fotemustine for patients with progressive malignant gliomas.
Agolli, L; Caporello, P; Enrici, RM; Esposito, V; Falco, T; Lanzetta, G; Minniti, G; Osti, MF; Scaringi, C, 2015
)
0.85

Bioavailability

ExcerptReferenceRelevance
" After intraperitoneal administration the absolute bioavailability remains limited (22."( Pharmacology of EAPB0203, a novel imidazo[1,2-a]quinoxaline derivative with anti-tumoral activity on melanoma.
Bonnet, PA; Bressolle, FM; Cooper, JF; Deleuze-Masquéfa, C; Gattacceca, F; Khier, S; Margout, D; Moarbess, G; Pinguet, F; Solassol, I, 2010
)
0.36
"The ATP-binding cassette transporter P-glycoprotein (P-gp) is known to limit both brain penetration and oral bioavailability of many chemotherapy drugs."( A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
Ambudkar, SV; Brimacombe, KR; Chen, L; Gottesman, MM; Guha, R; Hall, MD; Klumpp-Thomas, C; Lee, OW; Lee, TD; Lusvarghi, S; Robey, RW; Shen, M; Tebase, BG, 2019
)
0.51

Dosage Studied

The thiolate-active site of RR from melanoma was inhibited by the new nitrosourea anti-tumour drug fotemustine (IC50 = 10(-4) M)

ExcerptRelevanceReference
" The thiolate-active site of RR from melanoma was inhibited by the new nitrosourea anti-tumour drug fotemustine (IC50 = 10(-4) M as determined from a dose-response study)."( Ribonucleotide diphosphate reductase from human metastatic melanoma.
Elgren, TE; Hogenkamp, HP; MacFarlan, S; Nelson, LS; Schallreuter, KU; Yan-Sze, I, 1992
)
0.5
" Dosage was fotemustine 100 mg/m2 and dacarbazine 200 mg/m2 intravenously twice monthly on days 1 and 8, repeated for a maximum of six courses."( Fotemustine plus dacarbazine in advanced stage III malignant melanoma.
Binder, M; Dorffner, R; Glebowski, E; Pehamberger, H; Winkler, A; Wolff, K, 1992
)
2.11
" In a panel of 12 human cancer cell lines [melanoma (4), ovary (2), head and neck (3), lung (1), bladder (1), breast (1)], the dose-response curves of S 10036 (0-100 microM) were similar to those obtained with equimolar concentrations of BCNU and CCNU; they indicated a moderately more marked effect for two and an equal effect for six melanoma cell lines with S 10036 as compared with BCNU."( In vitro chemosensitivity testing of Fotemustine (S 10036), a new antitumor nitrosourea.
Bizzari, JP; Deloffre, P; Etienne, MC; Fischel, JL; Formento, P; Frenay, M; Gioanni, J; Milano, G, 1990
)
0.55
" We have recently shown wide interindividual variation in the depletion and subsequent regeneration of ATase in peripheral blood mononuclear cells (PMCs) following DTIC and this has now been extended to ascertain whether or not depletion is related to dosage of DTIC used and repeated treatment cycles of chemotherapy."( Dosage and cycle effects of dacarbazine (DTIC) and fotemustine on O6-alkylguanine-DNA alkyltransferase in human peripheral blood mononuclear cells.
Dougal, M; Lee, SM; Margison, GP; Thatcher, N, 1993
)
0.54
" A statistically significant relationship was seen between the development of severe haematological toxicity (WHO > or = 3) with increasing dosage of DTIC and significant subclinical pulmonary damage was seen in 11 patients where the lung function was monitored during the course of treatment."( Sequential administration of varying doses of dacarbazine and fotemustine in advanced malignant melanoma.
Lee, SM; Margison, GP; Thatcher, N; Woodcock, AA, 1993
)
0.53
" rIFN alpha 2a was administered at the dosage of 3 MIU subcutaneously 3 times a week until progression."( Fotemustine and dacarbazine plus recombinant interferon alpha 2a in thetreatment of advanced melanoma.
Caponigro, F; Casaretti, R; Comella, G; Comella, P; Daponte, A; Fiore, F; Frasci, G; Gravina, A; Ionna, F; Mozzillo, N; Parziale, AP; Presutti, F, 1997
)
1.74
" For both GLA salts, cytotoxicity was manifested after 4 days of cell exposure and with very sharp dose-response curves."( Cytotoxic effects of two gamma linoleic salts (lithium gammalinolenate or meglumine gammalinolenate) alone or associated with a nitrosourea: an experimental study on human glioblastoma cell lines.
Bryce, R; Etienne, MC; Ferrero, JM; Fischel, JL; Formento, P; Ilc, K; Milano, G, 1999
)
0.3
" Two patients in the first triplet had G3-G4 local toxicity, so that the scheduled F dosage was halved."( Phase I-II study on isolation antiblastic fotemustine perfusion after dacarbazine chemosensitization for advanced melanoma of the extremities.
De Salvo, GL; Foletto, M; Lejeune, FJ; Lise, M; Lopes, M; Mocellin, S; Pilati, PL; Pontes, L; Ribeiro, M; Rossi, CR, 2003
)
0.58
[information is derived through text-mining from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Drug Classes (3)

ClassDescription
organic phosphonate
N-nitrosoureasA nitroso compound that is any urea in which one of the nitrogens is substituted by a nitroso group
organochlorine compoundAn organochlorine compound is a compound containing at least one carbon-chlorine bond.
[compound class information is derived from Chemical Entities of Biological Interest (ChEBI), Hastings J, Owen G, Dekker A, Ennis M, Kale N, Muthukrishnan V, Turner S, Swainston N, Mendes P, Steinbeck C. (2016). ChEBI in 2016: Improved services and an expanding collection of metabolites. Nucleic Acids Res]

Protein Targets (2)

Potency Measurements

ProteinTaxonomyMeasurementAverage (µ)Min (ref.)Avg (ref.)Max (ref.)Bioassay(s)
EWS/FLI fusion proteinHomo sapiens (human)Potency0.01480.001310.157742.8575AID1259256
Spike glycoproteinSevere acute respiratory syndrome-related coronavirusPotency39.81070.009610.525035.4813AID1479145
[prepared from compound, protein, and bioassay information from National Library of Medicine (NLM), extracted Dec-2023]

Ceullar Components (1)

Processvia Protein(s)Taxonomy
virion membraneSpike glycoproteinSevere acute respiratory syndrome-related coronavirus
[Information is prepared from geneontology information from the June-17-2024 release]

Bioassays (53)

Assay IDTitleYearJournalArticle
AID1508630Primary qHTS for small molecule stabilizers of the endoplasmic reticulum resident proteome: Secreted ER Calcium Modulated Protein (SERCaMP) assay2021Cell reports, 04-27, Volume: 35, Issue:4
A target-agnostic screen identifies approved drugs to stabilize the endoplasmic reticulum-resident proteome.
AID1296008Cytotoxic Profiling of Annotated Libraries Using Quantitative High-Throughput Screening2020SLAS discovery : advancing life sciences R & D, 01, Volume: 25, Issue:1
Cytotoxic Profiling of Annotated and Diverse Chemical Libraries Using Quantitative High-Throughput Screening.
AID1347083qHTS for Inhibitors of the Functional Ribonucleoprotein Complex (vRNP) of Lassa (LASV) Arenavirus: Viability assay - alamar blue signal for LASV Primary Screen2020Antiviral research, 01, Volume: 173A cell-based, infectious-free, platform to identify inhibitors of lassa virus ribonucleoprotein (vRNP) activity.
AID1347103qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for OHS-50 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1346986P-glycoprotein substrates identified in KB-3-1 adenocarcinoma cell line, qHTS therapeutic library screen2019Molecular pharmacology, 11, Volume: 96, Issue:5
A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
AID1347108qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Rh41 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347106qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for control Hh wild type fibroblast cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1346987P-glycoprotein substrates identified in KB-8-5-11 adenocarcinoma cell line, qHTS therapeutic library screen2019Molecular pharmacology, 11, Volume: 96, Issue:5
A High-Throughput Screen of a Library of Therapeutics Identifies Cytotoxic Substrates of P-glycoprotein.
AID1347098qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for SK-N-SH cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347104qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for RD cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347102qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Rh18 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347105qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for MG 63 (6-TG R) cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347092qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for A673 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347090qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for DAOY cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347107qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Rh30 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1745845Primary qHTS for Inhibitors of ATXN expression
AID1347086qHTS for Inhibitors of the Functional Ribonucleoprotein Complex (vRNP) of Lymphocytic Choriomeningitis Arenaviruses (LCMV): LCMV Primary Screen - GLuc reporter signal2020Antiviral research, 01, Volume: 173A cell-based, infectious-free, platform to identify inhibitors of lassa virus ribonucleoprotein (vRNP) activity.
AID1347100qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for LAN-5 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347099qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for NB1643 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347097qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for Saos-2 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347093qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for SK-N-MC cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347154Primary screen GU AMC qHTS for Zika virus inhibitors2020Proceedings of the National Academy of Sciences of the United States of America, 12-08, Volume: 117, Issue:49
Therapeutic candidates for the Zika virus identified by a high-throughput screen for Zika protease inhibitors.
AID1347082qHTS for Inhibitors of the Functional Ribonucleoprotein Complex (vRNP) of Lassa (LASV) Arenavirus: LASV Primary Screen - GLuc reporter signal2020Antiviral research, 01, Volume: 173A cell-based, infectious-free, platform to identify inhibitors of lassa virus ribonucleoprotein (vRNP) activity.
AID1347094qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for BT-37 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347089qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for TC32 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347101qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for BT-12 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347095qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for NB-EBc1 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347096qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for U-2 OS cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347091qHTS of pediatric cancer cell lines to identify multiple opportunities for drug repurposing: Primary screen for SJ-GBM2 cells2018Oncotarget, Jan-12, Volume: 9, Issue:4
Quantitative high-throughput phenotypic screening of pediatric cancer cell lines identifies multiple opportunities for drug repurposing.
AID1347411qHTS to identify inhibitors of the type 1 interferon - major histocompatibility complex class I in skeletal muscle: primary screen against the NCATS Mechanism Interrogation Plate v5.0 (MIPE) Libary2020ACS chemical biology, 07-17, Volume: 15, Issue:7
High-Throughput Screening to Identify Inhibitors of the Type I Interferon-Major Histocompatibility Complex Class I Pathway in Skeletal Muscle.
AID1079947Comments (NB not yet translated). [column 'COMMENTAIRES' in source]
AID1079935Cytolytic liver toxicity, either proven histopathologically or where the ratio of maximal ALT or AST activity above normal to that of Alkaline Phosphatase is > 5 (see ACUTE). Value is number of references indexed. [column 'CYTOL' in source]
AID1079942Steatosis, proven histopathologically. Value is number of references indexed. [column 'STEAT' in source]
AID1079933Acute liver toxicity defined via clinical observations and clear clinical-chemistry results: serum ALT or AST activity > 6 N or serum alkaline phosphatases activity > 1.7 N. This category includes cytolytic, choleostatic and mixed liver toxicity. Value is
AID1079931Moderate liver toxicity, defined via clinical-chemistry results: ALT or AST serum activity 6 times the normal upper limit (N) or alkaline phosphatase serum activity of 1.7 N. Value is number of references indexed. [column 'BIOL' in source]
AID1079939Cirrhosis, proven histopathologically. Value is number of references indexed. [column 'CIRRH' in source]
AID1079940Granulomatous liver disease, proven histopathologically. Value is number of references indexed. [column 'GRAN' in source]
AID1079948Times to onset, minimal and maximal, observed in the indexed observations. [column 'DELAI' in source]
AID1079934Highest frequency of acute liver toxicity observed during clinical trials, expressed as a percentage. [column '% AIGUE' in source]
AID1079944Benign tumor, proven histopathologically. Value is number of references indexed. [column 'T.BEN' in source]
AID406725Cytotoxicity against human RPMI7591 cells after 96 hrs by MTT assay2008Bioorganic & medicinal chemistry, Jul-01, Volume: 16, Issue:13
In vitro and in vivo anti-tumoral activities of imidazo[1,2-a]quinoxaline, imidazo[1,5-a]quinoxaline, and pyrazolo[1,5-a]quinoxaline derivatives.
AID1079949Proposed mechanism(s) of liver damage. [column 'MEC' in source]
AID1079938Chronic liver disease either proven histopathologically, or through a chonic elevation of serum amino-transferase activity after 6 months. Value is number of references indexed. [column 'CHRON' in source]
AID1079943Malignant tumor, proven histopathologically. Value is number of references indexed. [column 'T.MAL' in source]
AID406724Cytotoxicity against human M4Be cells after 96 hrs by MTT assay2008Bioorganic & medicinal chemistry, Jul-01, Volume: 16, Issue:13
In vitro and in vivo anti-tumoral activities of imidazo[1,2-a]quinoxaline, imidazo[1,5-a]quinoxaline, and pyrazolo[1,5-a]quinoxaline derivatives.
AID1079946Presence of at least one case with successful reintroduction. [column 'REINT' in source]
AID433907Cytotoxicity against human A375 cells after 96 hrs by MTT assay2009European journal of medicinal chemistry, Sep, Volume: 44, Issue:9
New imidazo[1,2-a]quinoxaline derivatives: synthesis and in vitro activity against human melanoma.
AID1079936Choleostatic liver toxicity, either proven histopathologically or where the ratio of maximal ALT or AST activity above normal to that of Alkaline Phosphatase is < 2 (see ACUTE). Value is number of references indexed. [column 'CHOLE' in source]
AID1079937Severe hepatitis, defined as possibly life-threatening liver failure or through clinical observations. Value is number of references indexed. [column 'MASS' in source]
AID1079941Liver damage due to vascular disease: peliosis hepatitis, hepatic veno-occlusive disease, Budd-Chiari syndrome. Value is number of references indexed. [column 'VASC' in source]
AID406723Cytotoxicity against human A375 cells after 96 hrs by MTT assay2008Bioorganic & medicinal chemistry, Jul-01, Volume: 16, Issue:13
In vitro and in vivo anti-tumoral activities of imidazo[1,2-a]quinoxaline, imidazo[1,5-a]quinoxaline, and pyrazolo[1,5-a]quinoxaline derivatives.
AID1079932Highest frequency of moderate liver toxicity observed during clinical trials, expressed as a percentage. [column '% BIOL' in source]
AID1079945Animal toxicity known. [column 'TOXIC' in source]
[information is prepared from bioassay data collected from National Library of Medicine (NLM), extracted Dec-2023]

Research

Studies (274)

TimeframeStudies, This Drug (%)All Drugs %
pre-19909 (3.28)18.7374
1990's112 (40.88)18.2507
2000's77 (28.10)29.6817
2010's63 (22.99)24.3611
2020's13 (4.74)2.80
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Market Indicators

Research Demand Index: 38.68

According to the monthly volume, diversity, and competition of internet searches for this compound, as well the volume and growth of publications, there is estimated to be strong demand-to-supply ratio for research on this compound.

MetricThis Compound (vs All)
Research Demand Index38.68 (24.57)
Research Supply Index5.93 (2.92)
Research Growth Index5.60 (4.65)
Search Engine Demand Index52.00 (26.88)
Search Engine Supply Index2.00 (0.95)

This Compound (38.68)

All Compounds (24.57)

Study Types

Publication TypeThis drug (%)All Drugs (%)
Trials84 (28.77%)5.53%
Reviews34 (11.64%)6.00%
Case Studies24 (8.22%)4.05%
Observational0 (0.00%)0.25%
Other150 (51.37%)84.16%
[information is prepared from research data collected from National Library of Medicine (NLM), extracted Dec-2023]

Clinical Trials (9)

Trial Overview

TrialPhaseEnrollmentStudy TypeStart DateStatus
A Randomized, Phase III Study of Fotemustine Versus the Combination of Fotemustine and Ipilimumab or the Combination of Ipilimumab and Nivolumab in Patients With Metastatic Melanoma With Brain Metastasis [NCT02460068]Phase 3168 participants (Anticipated)Interventional2012-12-31Recruiting
An Open-label Study to Assess the Anti-tumor Activity of Avastin in Combination With Fotemustine as First-line Therapy in Patients With Metastatic Melanoma [NCT01069627]Phase 220 participants (Actual)Interventional2006-12-31Completed
Phase II Study of the Predictive Value of the Expression of Tumoral MGMT With Respect to the Therapeutic Response of Fotemustine in Patients With Metastatic Malignant Melanoma [NCT00560118]Phase 260 participants (Anticipated)Interventional2003-08-31Completed
The Prospective Study of FTD Program and HD-MTX-Ara-C Program Contrast in the Treatment of PCNSL Lymphoma. [NCT05274139]Phase 220 participants (Actual)Interventional2017-03-02Completed
A Phase II Single-arm Study for the Treatment After Recurrence of Advanced Melanoma Patients Harboring the V600BRAF Mutation and Pretreated With Vemurafenib, With the Association of Vemurafenib Plus Fotemustine. [NCT01983124]Phase 231 participants (Actual)Interventional2013-02-28Completed
Intravenous Versus Intra-Arterial Fotemustine Chemotherapy in Patients With Liver Metastases From Uveal Melanoma: A Randomized Phase III Study of the EORTC Melanoma Group [NCT00110123]Phase 3171 participants (Actual)Interventional2005-01-31Terminated(stopped due to low accrual)
Fotemustine and Dacarbazine Versus Dacarbazine +/- Alpha Interferon in Advanced Malignant Melanoma: Phase III Study [NCT01359956]Phase 3269 participants (Actual)Interventional2002-04-30Completed
A Phase II Study of the Combination of Ipilimumab and Fotemustine in Patients With Unresectable Locally Advanced or Metastatic Malignant Melanoma [NCT01654692]Phase 286 participants (Actual)Interventional2010-06-30Completed
Randomized Non Comparative Phase II Trial With Bevacizumab and Fotemustine in the Treatment of Recurrent Glioblastoma [NCT01474239]Phase 291 participants (Actual)Interventional2011-11-30Completed
[information is prepared from clinicaltrials.gov, extracted Sep-2024]

Trial Outcomes

TrialOutcome
NCT01069627 (18) [back to overview]Duration of CR - Percentage of Participants With an Event
NCT01069627 (18) [back to overview]Duration of CR - Time to Event
NCT01069627 (18) [back to overview]Duration of Overall Response of CR or PR - Percentage of Participants With an Event
NCT01069627 (18) [back to overview]Duration of Overall Response of CR or PR - Time to Event
NCT01069627 (18) [back to overview]Duration of Stable Disease - Percentage of Participants With an Event
NCT01069627 (18) [back to overview]Duration of Stable Disease - Time to Event
NCT01069627 (18) [back to overview]OS - Time to Event
NCT01069627 (18) [back to overview]Overall Survival (OS) - Percentage of Participants With an Event
NCT01069627 (18) [back to overview]Percentage of Participants With Clinical Benefit of CR, PR, or Stable Disease (SD)
NCT01069627 (18) [back to overview]Percentage of Participants With Complete Response (CR) or Partial Response (PR)
NCT01069627 (18) [back to overview]Time to CR - Percentage of Participants With an Event
NCT01069627 (18) [back to overview]Time to CR - Time To Event
NCT01069627 (18) [back to overview]Time to Overall Response of CR or PR - Percentage of Participants With an Event
NCT01069627 (18) [back to overview]Time to Overall Response of CR or PR - Time to Event
NCT01069627 (18) [back to overview]Time to Progression (TTP) - Percentage of Participants With an Event
NCT01069627 (18) [back to overview]Time to Treatment Failure (TTF) - Percentage of Participants With an Event
NCT01069627 (18) [back to overview]TTF - Time to Event
NCT01069627 (18) [back to overview]TTP - Time to Event
NCT01359956 (4) [back to overview]Overall Response Rate (ORR)
NCT01359956 (4) [back to overview]Overall Survival (OS)
NCT01359956 (4) [back to overview]Progression Free Survival (PFS)
NCT01359956 (4) [back to overview]Treatment Related Toxicity
NCT01474239 (16) [back to overview]Overall Survival (OS)
NCT01474239 (16) [back to overview]Percentage of Participants Alive 12 Months After Start of Treatment
NCT01474239 (16) [back to overview]Percentage of Participants Alive 30 Days After Last Dose of Study Drug
NCT01474239 (16) [back to overview]Percentage of Participants Alive 6 Months After Start of Treatment
NCT01474239 (16) [back to overview]Percentage of Participants Alive 9 Months After Start of Treatment
NCT01474239 (16) [back to overview]Percentage of Participants Who Were Alive and Progression Free 6 Months After Start of Treatment
NCT01474239 (16) [back to overview]Percentage of Participants With Corticosteroid Initiation During the Study Period
NCT01474239 (16) [back to overview]Percentage of Participants With Karnofsky Performance Status (KPS) Deterioration
NCT01474239 (16) [back to overview]Percentage of Participants With World Health Organization (WHO) Performance Status (PS) Deterioration
NCT01474239 (16) [back to overview]Progression-Free Survival (PFS)
NCT01474239 (16) [back to overview]Time to Corticosteroid Initiation
NCT01474239 (16) [back to overview]Time to Karnofsky Performance Status (KPS) Deterioration
NCT01474239 (16) [back to overview]Time to WHO PS Deterioration
NCT01474239 (16) [back to overview]Change From Screening in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Scores at Weeks 8, 16, 24, 32, 40, 48, 56, 64, and 72
NCT01474239 (16) [back to overview]Percentage of Participants in Each Class of Corticosteroid Use
NCT01474239 (16) [back to overview]Percentage of Participants With a Best Overall Response of Complete Response (CR) or Partial Response (PR)

Duration of CR - Percentage of Participants With an Event

Evaluated only for participants whose best overall response was CR. The start date was the date of first documented CR and the end date was defined as the date of first documented progression of disease, or death. Participants who did not experience progression of disease were censored at last tumor assessment date or at maximum follow-up. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventionpercentage of participants (Number)
Bevacizumab + Fotemustine0

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Duration of CR - Time to Event

The start date was the date of first documented CR and the end date was defined as the date of first documented progression of disease, or death. Participants who did not experience progression of disease were censored at last tumor assessment date or at maximum follow-up. Median duration of CR was estimated using the Kaplan-Meier method. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventiondays (Median)
Bevacizumab + FotemustineNA

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Duration of Overall Response of CR or PR - Percentage of Participants With an Event

The start date was the date of first documented CR or PR and the end date was defined as the date of first documented progression of disease, or death. Participants who did not experience progression of disease were censored at last tumor assessment date or at maximum follow-up. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventionpercentage of participants (Number)
Bevacizumab + Fotemustine66.67

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Duration of Overall Response of CR or PR - Time to Event

The start date was the date of first documented CR or PR and the end date was defined as the date of first documented progression of disease. Participants who did not experience progression of disease were censored at last tumor assessment date or at maximum follow-up. Median duration of CR or PR was estimated using the Kaplan-Meier method. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventiondays (Median)
Bevacizumab + Fotemustine324.00

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Duration of Stable Disease - Percentage of Participants With an Event

Stable disease was defined as achieving CR, PR, or SD. The start date was the date of first documented CR, PR, or SD and the end date was defined as the date of first documented progression of disease, or death. Participants who did not experience progression of disease were censored at last tumor assessment date or at maximum follow-up. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventionpercentage of participants (Number)
Bevacizumab + Fotemustine58.33

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Duration of Stable Disease - Time to Event

Stable disease was defined as achieving CR, PR, or SD. The start date was the date of first documented CR, PR, or SD and the end date was defined as the date of first documented progression of disease, or death. Participants who did not experience progression of disease were censored at last tumor assessment date or at maximum follow-up. Median duration of CR, PR, or SD was estimated using the Kaplan-Meier method. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventiondays (Median)
Bevacizumab + Fotemustine619.00

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OS - Time to Event

The time from the starting day of the therapy up to death or the last date the participant was known to be alive. Median OS was estimated using the Kaplan-Meier method. (NCT01069627)
Timeframe: Baseline, every 3 weeks to end-of-treatment, every 3 months during follow-up, to death or end-of-study (maximum of 36 months)

Interventiondays (Median)
Bevacizumab + Fotemustine615.00

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Overall Survival (OS) - Percentage of Participants With an Event

OS was defined as the time from the starting day of the therapy up to death or the last date the participant was known to be alive. (NCT01069627)
Timeframe: Baseline, every 3 weeks to end-of-treatment, every 3 months during follow-up, to death or end-of-study (maximum of 36 months)

Interventionpercentage of participants (Number)
Bevacizumab + Fotemustine60

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Percentage of Participants With Clinical Benefit of CR, PR, or Stable Disease (SD)

The percentage of participants with an objective response of CR, PR, or SD, as evaluated by RECIST criteria. CR: disappearance of all clinical and radiological evidence of tumor (both target and non-target), PR: at least a 30% decrease in the sum of the LD of target lesions taking as reference the baseline sum LD. SD: steady state of disease. Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for pregressive disease (PD). The clinical benefit was finally assessed by computing absolute frequencies and percentages participants with best overall tumor response equal to CR, PR, or SD. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventionpercentage of participants (Number)
Bevacizumab + Fotemustine65

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Percentage of Participants With Complete Response (CR) or Partial Response (PR)

The percentage of participants with an objective response, defined as achieving CR or PR, as evaluated by the Response Evaluation Criteria In Solid Tumors (RECIST) criteria. CR: disappearance of all clinical and radiological evidence of tumor (both target and non-target), PR: at least a 30 percent (%) decrease in the sum of the longest diameter (LD) of target lesions taking as reference the baseline sum LD. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventionpercentage of participants (Number)
Bevacizumab + Fotemustine15

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Time to CR - Percentage of Participants With an Event

The time between date of start of treatment until first documented CR. This analysis included all responders. Participants who did not achieve a confirmed CR were censored at last adequate tumour assessment date or at maximum follow-up. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventionpercentage of participants (Number)
Bevacizumab + Fotemustine5.26

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Time to CR - Time To Event

The time between date of start of treatment until first documented CR. This analysis included all responders. Participants who did not achieve a confirmed CR were censored at last adequate tumour assessment date or at maximum follow-up. Mean time to CR was estimated using the Kaplan-Meier method. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventiondays (Mean)
Bevacizumab + Fotemustine76.00

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Time to Overall Response of CR or PR - Percentage of Participants With an Event

The time between date of start of treatment until first documented response of CR or PR. This analysis included all responders. Participants who did not achieve a confirmed CR or PR were censored at last adequate tumour assessment date or at maximum follow-up. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventionpercentage of participants (Number)
Bevacizumab + Fotemustine15.79

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Time to Overall Response of CR or PR - Time to Event

The time between date of start of treatment until first documented response of CR or PR. This analysis included all responders. Participants who did not achieve a confirmed CR or PR were censored at last adequate tumor assessment date or at maximum follow-up. Mean time to CR or PR was estimated using the Kaplan-Meier method. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventiondays (Mean)
Bevacizumab + Fotemustine116.50

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Time to Progression (TTP) - Percentage of Participants With an Event

TTP was defined as the time in days from the date of first study treatment until the date of tumor progression or death. Failure events were defined as occurrence of death or progression of disease. Data for participants who were alive without tumor progression at the end of the study were censured at the end of the observation period. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventionpercentage of participants (Number)
Bevacizumab + Fotemustine73.68

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Time to Treatment Failure (TTF) - Percentage of Participants With an Event

The time from date of start of treatment to the earliest among date of progression, date of death due to any cause, or date of discontinuation due to reason other than 'Protocol Violation' or 'Administrative Problem'. For the participants who did not experience treatment failure, TTF was censored at last adequate tumour assessment. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventionpercentage of participants (Number)
Bevacizumab + Fotemustine100

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TTF - Time to Event

The time from date of start of treatment to the earliest among date of progression, date of death due to any cause, or date of discontinuation due to reason other than 'Protocol Violation' or 'Administrative Problem'. For the participants who did not experience treatment failure, TTF was censored at last adequate tumour assessment. Median TTF was estimated using the Kaplan-Meier method. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventiondays (Median)
Bevacizumab + Fotemustine126.00

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TTP - Time to Event

TTP was defined as the time in days from the of first study treatment until the date of tumor progression or death. Failure events were defined as occurrence of death or progression of disease. Data for participants who were alive without tumor progression at the end of the study were censored at the end of the observation period. Median TTP was estimated using the Kaplan-Meier method. (NCT01069627)
Timeframe: Baseline, every 9 weeks during study treatment, and every 3 months during follow-up, up to 36 months

Interventiondays (Median)
Bevacizumab + Fotemustine249.00

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Overall Response Rate (ORR)

"Overall Response Rate (ORR) included Complete Response (CR) and Partial Response (PR).~Complete Response (CR) was defined as disappearance of all symptoms and signs of all measurable disease, lasting for at least four weeks, without appearance of new lesions.~Partial Response (PR) was defined as a > 50% reduction in the sum of the products of the perpendicular diameters of all measurable lesions, lasting for at least four weeks, without appearance of new lesions or enlargement of existing lesions." (NCT01359956)
Timeframe: 18 weeks from start of therapy

Interventionparticipants (Number)
Fotemustine/Dacarbazine/Interferon + Fotemustine/Dacarbazine32
Dacarbazine/Interferon + Dacarbazine33
Fotemustine/Dacarbazine/Interferon+Dacarbazine/Interferon34
Fotemustine/Dacarbazine + Dacarbazine31

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Overall Survival (OS)

"Overall Survival was defined as the time from the date of randomisation to the date of death from any cause or the date of last follow-up for living patients.~OS curves were estimated with the Kaplan - Meier (K-M) method and treatments were compared with a two - sided log - rank test." (NCT01359956)
Timeframe: 24 months

InterventionMonths (Median)
Fotemustine/Dacarbazine/Interferon + Fotemustine/Dacarbazine7.9
Dacarbazine/Interferon + Dacarbazine8.6
Fotemustine/Dacarbazine/Interferon+Dacarbazine/Interferon9.1
Fotemustine/Dacarbazine + Dacarbazine7.7

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Progression Free Survival (PFS)

"Progression Free Survival (PFS) was defined as the time from the date of randomisation to the date of progression of disease or death from any cause, whichever occurred first, or date of last follow-up for patients without progression and alive at the end of the study.~PFS curves were estimated with the Kaplan - Meier (K-M) method and treatments were compared with a two-sided log-rank test." (NCT01359956)
Timeframe: 12 months

InterventionMonths (Median)
Fotemustine/Dacarbazine/Interferon + Fotemustine/Dacarbazine2.7
Dacarbazine/Interferon + Dacarbazine2.5
Fotemustine/Dacarbazine/Interferon+Dacarbazine/Interferon2.8
Fotemustine/Dacarbazine + Dacarbazine2.5

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Overall Survival (OS)

OS was defined as the time in months from the start of treatment to death due to any cause. If a participant was not known to have died, time was censored at the last date the participant was known to be alive, which was defined as the latest among date of last visit, date of last sample collected for laboratory exam, date of MRI assessment, date of last treatment, date of discontinuation and date of last available follow-up visit. Participants with no information after baseline were censored at Day 1. OS was estimated by the Kaplan-Meier method. (NCT01474239)
Timeframe: Baseline until death (up to 691 days)

Interventionmonths (Median)
Bevacizumab7.26
Fotemustine8.66

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Percentage of Participants Alive 12 Months After Start of Treatment

OS was defined as the time in months from the start of treatment to death due to any cause. If a participant was not known to have died, time was censored at the last date the participant was known to be alive, which was defined as the latest among date of last visit, date of last sample collected for laboratory exam, date of MRI assessment, date of last treatment, date of discontinuation and date of last available follow-up visit. Participants with no information after baseline were censored at Day 1. OS was estimated by the Kaplan-Meier method. (NCT01474239)
Timeframe: 12 months

Interventionpercentage of participants (Number)
Bevacizumab25.86
Fotemustine40.00

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Percentage of Participants Alive 30 Days After Last Dose of Study Drug

OS was defined as the time in months from the start of treatment to death due to any cause. If a participant was not known to have died, time was censored at the last date the participant was known to be alive, which was defined as the latest among date of last visit, date of last sample collected for laboratory exam, date of MRI assessment, date of last treatment, date of discontinuation and date of last available follow-up visit. Participants with no information after baseline were censored at Day 1. OS was estimated by the Kaplan-Meier method. (NCT01474239)
Timeframe: 30 days after last dose of study drug (up to Day 600)

Interventionpercentage of participants (Number)
Bevacizumab93.10
Fotemustine90.00

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Percentage of Participants Alive 6 Months After Start of Treatment

Overall survival (OS) was defined as the time in months from the start of treatment to death due to any cause. If a participant was not known to have died, time was censored at the last date the participant was known to be alive, which was defined as the latest among date of last visit, date of last sample collected for laboratory exam, date of magnetic resonance imaging (MRI) assessment, date of last treatment, date of discontinuation and date of last available follow-up visit. Participants with no information after baseline were censored at Day 1. OS was estimated by the Kaplan-Meier method. (NCT01474239)
Timeframe: 6 months

Interventionpercentage of participants (Number)
Bevacizumab62.07
Fotemustine73.33

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Percentage of Participants Alive 9 Months After Start of Treatment

OS was defined as the time in months from the start of treatment to death due to any cause. If a participant was not known to have died, time was censored at the last date the participant was known to be alive, which was defined as the latest among date of last visit, date of last sample collected for laboratory exam, date of MRI assessment, date of last treatment, date of discontinuation and date of last available follow-up visit. Participants with no information after baseline were censored at Day 1. OS was estimated by the Kaplan-Meier method. (NCT01474239)
Timeframe: 9 months

Interventionpercentage of participants (Number)
Bevacizumab37.93
Fotemustine46.67

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Percentage of Participants Who Were Alive and Progression Free 6 Months After Start of Treatment

Progression-free survival (PFS) was defined as the time in months from the start of treatment to the date of the first occurrence of disease progression or death from any cause, whichever occurred first. PFS was estimated by the Kaplan-Meier method. Progression was assessed using Response Assessment in Neuro-Oncology (RANO) or Macdonald Response Criteria, whichever occurred first. As per the RANO criteria, progression was defined as 25% or more increase in enhancing lesions despite stable or increasing steroid dose; increase (significant) in non-enhancing T2/FLAIR lesions, not attributable to other non-tumor causes; any new lesions; and clinical deterioration (not attributable to other non-tumor causes and not due to steroid decrease). As per the Macdonald criteria, progression was defined as 25% or more increase in enhancing lesions; any new lesions; and clinical deterioration. (NCT01474239)
Timeframe: 6 months

Interventionpercentage of participants (Number)
Bevacizumab26.32
Fotemustine10.71

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Percentage of Participants With Corticosteroid Initiation During the Study Period

Corticosteroid initiation was assessed in participants not receiving corticosteroids at screening. The participant had the event if he/she started on corticosteroids with a dosage greater than equal to (>/=) 2 mg dexamethasone equivalent. (NCT01474239)
Timeframe: Baseline until recurrence (up to 691 days)

Interventionpercentage of participants (Number)
Bevacizumab58.82
Fotemustine41.67

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Percentage of Participants With Karnofsky Performance Status (KPS) Deterioration

Deterioration of KPS was defined as a decrease of at least 20 percentage points with respect to the screening. KPS is an 11-level score which ranges between 0 (death) to 100 (complete healthy status); a higher score represents a higher ability to perform daily tasks. (NCT01474239)
Timeframe: Baseline until KPS deterioration (up to 691 days)

Interventionpercentage of participants (Number)
Bevacizumab18.92
Fotemustine14.29

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Percentage of Participants With World Health Organization (WHO) Performance Status (PS) Deterioration

WHO PS deterioration was defined as a decrease of at least 1 point with respect to the screening value. WHO PS is a 6-level score which ranges between 0 (fully active) to 5 (death); a lower score represents a higher ability to perform daily tasks. (NCT01474239)
Timeframe: Baseline until WHO PS deterioration (Up to 691 days)

Interventionpercentage of participants (Number)
Bevacizumab47.46
Fotemustine37.50

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Progression-Free Survival (PFS)

PFS was defined as the time in months from the start of treatment to the date of the first occurrence of disease progression or death from any cause, whichever occurred first. PFS was estimated by the Kaplan-Meier method. Progression was assessed using the RANO or the Macdonald Response Criteria, whichever occurred first. As per RANO criteria, progression was defined as 25% or more increase in enhancing lesions despite stable or increasing steroid dose; increase (significant) in non-enhancing T2/FLAIR lesions, not attributable to other non-tumor causes; any new lesions; and clinical deterioration (not attributable to other non-tumor causes and not due to steroid decrease). As per Macdonald criteria, progression was defined as 25% or more increase in enhancing lesions; any new lesions; and clinical deterioration. (NCT01474239)
Timeframe: Baseline until disease progression or death (baseline, 46 days after first administration of study drug, and thereafter every 56 days up to 691 days)

Interventionmonths (Median)
Bevacizumab3.38
Fotemustine3.45

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Time to Corticosteroid Initiation

Time to corticosteroid initiation was defined as the time from screening to the start date of the first corticosteroid administration in participants not receiving corticosteroids at screening. The participant had the event if he/she started on corticosteroids with a dosage ≥2 mg dexamethasone equivalent. Instead, if the participant was not known to have the event, time was censored at the last available visit date. Time to corticosteroid initiation was estimated using Kaplan Meier method. (NCT01474239)
Timeframe: Baseline until recurrence (up to 691 days)

Interventionmonths (Median)
Bevacizumab4.49
Fotemustine5.93

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Time to Karnofsky Performance Status (KPS) Deterioration

Time to KPS deterioration was defined as the time from screening to the first date of deterioration of the KPS score. Deterioration of KPS was defined as a decrease of at least 20 percentage points with respect to the screening. KPS is an 11-level score which ranges between 0 (death) to 100 (complete healthy status); a higher score represents a higher ability to perform daily tasks. Time to KPS deterioration was estimated using Kaplan Meier method. If the participant was not known to have the event, time was censored at the last available visit date. (NCT01474239)
Timeframe: Baseline until KPS deterioration (up to 691 days)

Interventionmonths (Median)
BevacizumabNA
FotemustineNA

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Time to WHO PS Deterioration

Time to WHO PS deterioration was defined as the time from randomization to the first date of deterioration of the WHO performance status score. WHO PS deterioration was defined as a decrease of at least 1 point with respect to the screening value. WHO PS is a 6-level score which ranges between 0 (fully active) to 5 (death); a lower score represents a higher ability to perform daily tasks. (NCT01474239)
Timeframe: Baseline until WHO PS deterioration (Up to 691 days)

Interventionmonths (Median)
Bevacizumab8.87
FotemustineNA

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Change From Screening in European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Scores at Weeks 8, 16, 24, 32, 40, 48, 56, 64, and 72

EORTC QLQ-C30: included global health status/quality of life (QOL), functional scales (physical, role, cognitive, emotional, and social), symptom scales (fatigue, pain, nausea/vomiting), and single items (dyspnea, appetite loss, insomnia, constipation, diarrhea, and financial difficulties). Most questions used a 4-point scale (1 'Not at All' to 4 'Very Much'); 2 questions used a 7-point scale (1 'Very Poor' to 7 'Excellent'). Scores were averaged and transformed to 0-100 scale; a higher score for Global QOL/functional scales indicates better level of QOL/functioning, or a higher score for symptom scale indicates greater degree of symptoms. (NCT01474239)
Timeframe: Screening, Weeks 8, 16, 24, 32, 40, 48, 56, 64, and 72

,
Interventionunits on a scale (Mean)
Physical Functioning (Fn): Screening (n=58,31)Physical Fn: Change at Week 8 (n=27,16)Physical Fn: Change at Week 16 (n=15,7)Physical Fn: Change at Week 24 (n=14,1)Physical Fn: Change at Week 32 (n=7,2)Physical Fn: Change at Week 40 (n=9,1)Physical Fn: Change at Week 48 (n=4,1)Physical Fn: Change at Week 56 (n=4,0)Physical Fn: Change at Week 64 (n=1,0)Physical Fn: Change at Week 72 (n=1,0)Role Fn: Screening (n=58,31)Role Fn: Change at Week 8 (n=27,16)Role Fn: Change at Week 16 (n=15,7)Role Fn: Change at Week 24 (n=14,1)Role Fn: Change at Week 32 (n=7,2)Role Fn: Change at Week 40 (n=9,1)Role Fn: Change at Week 48 (n=4,1)Role Fn: Change at Week 56 (n=4,0)Role Fn: Change at Week 64 (n=1,0)Role Fn: Change at Week 72 (n=1,0)Emotional Fn: Screening (n=58,31)Emotional Fn: Change at Week 8 (n=27,16)Emotional Fn: Change at Week 16 (n=15,7)Emotional Fn: Change at Week 24 (n=14,1)Emotional Fn: Change at Week 32 (n=7,2)Emotional Fn: Change at Week 40 (n=9,1)Emotional Fn: Change at Week 48 (n=4,1)Emotional Fn: Change at Week 56 (n=4,0)Emotional Fn: Change at Week 64 (n=1,0)Emotional Fn: Change at Week 72 (n=1,0)Cognitive Fn: Screening (n=58,31)Cognitive Fn: Change at Week 8 (n=27,16)Cognitive Fn: Change at Week 16 (n=15,7)Cognitive Fn: Change at Week 24 (n=14,1)Cognitive Fn: Change at Week 32 (n=7,2)Cognitive Fn: Change at Week 40 (n=9,1)Cognitive Fn: Change at Week 48 (n=4,1)Cognitive Fn: Change at Week 56 (n=4,0)Cognitive Fn: Change at Week 64 (n=1,0)Cognitive Fn: Change at Week 72 (n=1,0)Social Fn: Screening (n=58,31)Social Fn: Change at Week 8 (n=27,16)Social Fn: Change at Week 16 (n=15,7)Social Fn: Change at Week 24 (n=14,1)Social Fn: Change at Week 32 (n=7,2)Social Fn: Change at Week 40 (n=9,1)Social Fn: Change at Week 48 (n=4,1)Social Fn: Change at Week 56 (n=4,0)Social Fn: Change at Week 64 (n=1,0)Social Fn: Change at Week 72 (n=1,0)QOL: Screening (n=58,31)QOL: Change at Week 8 (n=27,16)QOL: Change at Week 16 (n=15,7)QOL: Change at Week 24 (n=14,1)QOL: Change at Week 32 (n=7,2)QOL: Change at Week 40 (n=9,1)QOL: Change at Week 48 (n=4,1)QOL: Change at Week 56 (n=4,0)QOL: Change at Week 64 (n=1,0)QOL: Change at Week 72 (n=1,0)Fatigue: Screening (n=58,31)Fatigue: Change at Week 8 (n=27,16)Fatigue: Change at Week 16 (n=15,7)Fatigue: Change at Week 24 (n=14,1)Fatigue: Change at Week 32 (n=7,2)Fatigue: Change at Week 40 (n=9,1)Fatigue: Change at Week 48 (n=4,1)Fatigue: Change at Week 56 (n=4,0)Fatigue: Change at Week 64 (n=1,0)Fatigue: Change at Week 72 (n=1,0)Nausea: Screening (n=58,31)Nausea: Change at Week 8 (n=27,16)Nausea: Change at Week 16 (n=15,7)Nausea: Change at Week 24 (n=14,1)Nausea: Change at Week 32 (n=7,2)Nausea: Change at Week 40 (n=9,1)Nausea: Change at Week 48 (n=4,1)Nausea: Change at Week 56 (n=4,0)Nausea: Change at Week 64 (n=1,0)Nausea: Change at Week 72 (n=1,0)Pain: Screening (n=58,31)Pain: Change at Week 8 (n=27,16)Pain: Change at Week 16 (n=15,7)Pain: Change at Week 24 (n=14,1)Pain: Change at Week 32 (n=7,2)Pain: Change at Week 40 (n=9,1)Pain: Change at Week 48 (n=4,1)Pain: Change at Week 56 (n=4,0)Pain: Change at Week 64 (n=1,0)Pain: Change at Week 72 (n=1,0)Dyspnea: Screening (n=58,31)Dyspnea: Change at Week 8 (n=27,16)Dyspnea: Change at Week 16 (n=15,7)Dyspnea: Change at Week 24 (n=14,1)Dyspnea: Change at Week 32 (n=7,2)Dyspnea: Change at Week 40 (n=9,1)Dyspnea: Change at Week 48 (n=4,1)Dyspnea: Change at Week 56 (n=4,0)Dyspnea: Change at Week 64 (n=1,0)Dyspnea: Change at Week 72 (n=1,0)Insomnia: Screening (n=58,31)Insomnia: Change at Week 8 (n=27,16)Insomnia: Change at Week 16 (n=15,7)Insomnia: Change at Week 24 (n=14,1)Insomnia: Change at Week 32 (n=7,2)Insomnia: Change at Week 40 (n=9,1)Insomnia: Change at Week 48 (n=4,1)Insomnia: Change at Week 56 (n=4,0)Insomnia: Change at Week 64 (n=1,0)Insomnia: Change at Week 72 (n=1,0)Appetite loss: Screening (n=58,31)Appetite loss: Change at Week 8 (n=27,16)Appetite loss: Change at Week 16 (n=15,7)Appetite loss: Change at Week 24 (n=14,1)Appetite loss: Change at Week 32 (n=7,2)Appetite loss: Change at Week 40 (n=9,1)Appetite loss: Change at Week 48 (n=4,1)Appetite loss: Change at Week 56 (n=4,0)Appetite loss: Change at Week 64 (n=1,0)Appetite loss: Change at Week 72 (n=1,0)Constipation: Screening (n=58,31)Constipation: Change at Week 8 (n=26,16)Constipation: Change at Week 16 (n=15,7)Constipation: Change at Week 24 (n=14,1)Constipation: Change at Week 32 (n=7,2)Constipation: Change at Week 40 (n=9,1)Constipation: Change at Week 48 (n=4,1)Constipation: Change at Week 56 (n=4,0)Constipation: Change at Week 64 (n=1,0)Constipation: Change at Week 72 (n=1,0)Diarrhea: Screening (n=58,31)Diarrhea: Change at Week 8 (n=27,16)Diarrhea: Change at Week 16 (n=15,7)Diarrhea: Change at Week 24 (n=14,1)Diarrhea: Change at Week 32 (n=7,2)Diarrhea: Change at Week 40 (n=9,1)Diarrhea: Change at Week 48 (n=4,1)Diarrhea: Change at Week 56 (n=4,0)Diarrhea: Change at Week 64 (n=1,0)Diarrhea: Change at Week 72 (n=1,0)Financial Fn: Screening (n=58,31)Financial Fn: Change at Week 8 (n=27,16)Financial Fn: Change at Week 16 (n=15,7)Financial Fn: Change at Week 24 (n=14,1)Financial Fn: Change at Week 32 (n=7,2)Financial Fn: Change at Week 40 (n=9,1)Financial Fn: Change at Week 48 (n=4,1)Financial Fn: Change at Week 56 (n=4,0)Financial Fn: Change at Week 64 (n=1,0)Financial Fn: Change at Week 72 (n=1,0)
Bevacizumab71.9510.377.5613.8118.104.443.336.670.000.0067.826.172.2214.2916.670.000.00-12.50-50.00-50.0073.56-8.02-0.5610.12-2.38-5.5614.58-4.178.338.3370.404.942.2210.710.00-1.850.00-4.1716.6716.6772.991.851.1113.10-7.14-5.56-4.17-12.50-66.67-66.6758.05-3.09-4.444.763.57-2.7810.422.080.000.0031.99-3.292.22-6.353.179.88-8.332.780.000.002.011.850.00-5.95-2.38-9.260.00-4.17-16.67-16.676.90-1.85-10.00-8.330.00-7.41-29.170.00-16.67-16.6711.494.940.00-9.520.003.70-8.330.000.000.0018.391.232.22-9.5228.5714.8125.0033.330.000.007.470.00-2.22-7.14-4.76-7.41-16.67-16.670.000.0017.823.854.442.38-0.003.70-16.670.00-33.33-33.331.150.00-6.67-7.14-4.760.000.000.000.000.0017.826.172.22-4.760.00-3.70-16.67-8.330.000.00
Fotemustine78.927.088.570.0013.336.676.67NANANA73.664.172.380.000.000.000.00NANANA74.198.33-2.38-33.3316.678.338.33NANANA79.037.29-4.760.008.330.000.00NANANA81.184.17-2.380.008.3316.6716.67NANANA66.136.257.140.00-12.500.000.00NANANA24.01-13.19-9.52-11.11-5.56-11.11-11.11NANANA1.08-8.33-14.290.000.000.00-16.67NANANA14.52-6.25-2.380.00-8.330.000.00NANANA3.23-6.254.760.000.000.000.00NANANA18.28-8.33-4.76-33.3316.6733.3333.33NANANA5.38-10.42-14.290.000.000.000.00NANANA17.20-4.17-9.520.0016.670.000.00NANANA2.150.000.000.000.000.000.00NANANA25.81-4.179.520.00-16.670.000.00NANANA

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Percentage of Participants in Each Class of Corticosteroid Use

Corticosteroid use was classified as: 1. No Change (if corticosteroid dose at each assessment was equal to baseline); 2. Decreased (if corticosteroid dose at each assessment was lower than baseline); 3. Increased (corticosteroid dose at each assessment was greater than baseline). (NCT01474239)
Timeframe: Weeks 8, 16, 24, 32, 40, 48, 56, 64, 72, 80, 88, post-treatment follow-up (up to Day 691)

,
Interventionpercentage of participants (Number)
Week 8: Increased (n=52,28)Week 8: Decreased (n=52,28)Week 8: No Change (n=52,28)Week 16: Increased (n=33,18)Week 16: Decreased (n=33,18)Week 16: No Change (n=33,18)Week 24: Increased (n=21,5)Week 24: Decreased (n=21,5)Week 24: No Change (n=21,5)Week 32: Increased (n=14,3)Week 32: Decreased (n=14,3)Week 32: No Change (n=14,3)Week 40: Increased (n=10,2)Week 40: Decreased (n=10,2)Week 40: No Change (n=10,2)Week 48: Increased (n=8,1)Week 48: Decreased (n=8,1)Week 48: No Change (n=8,1)Week 56: Increased (n=6,1)Week 56: Decreased (n=6,1)Week 56: No Change (n=6,1)Week 64: Increased (n=3,1)Week 64: Decreased (n=3,1)Week 64: No Change (n=3,1)Week 72: Increased (n=3,0)Week 72: Decreased (n=3,0)Week 72: No Change (n=3,0)Week 80: Increased (n=1,0)Week 80: Decreased (n=1,0)Week 80: No Change (n=1,0)Week 88: Increased (n=1,0)Week 88: Decreased (n=1,0)Week 88: No Change (n=1,0)Follow-up: Increased (n=9,3)Follow-up: Decreased (n=9,3)Follow-up: No Change (n=9,3)
Bevacizumab17.3123.0859.6221.2136.3642.4228.5733.3338.1014.2942.8642.860.0060.0040.000.0050.0050.000.0033.3366.670.000.00100.000.000.00100.000.000.00100.00100.000.000.0033.330.0066.67
Fotemustine17.8621.4360.7122.2227.7850.0020.0040.0040.0033.330.0066.6750.000.0050.000.000.00100.000.000.00100.000.000.00100.00NANANANANANANANANA0.0033.3366.67

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Percentage of Participants With a Best Overall Response of Complete Response (CR) or Partial Response (PR)

Percentage of participants achieving CR or PR as overall response between first drug administration and documented disease progression were calculated. Tumor response was evaluated according to both the RANO and the Macdonald response criteria. As per Macdonald criteria, CR was defined as the disappearance of all enhancing disease, sustained for at least 4 weeks, and no new lesions along with clinical features of clinically stable or improved, with no corticosteroid; PR was defined as a 50% or more decrease of all measurable enhancing lesions, sustained for at least 4 weeks, and no new lesion along with clinical features of clinically stable or improved, with stable or reduced corticosteroids. RANO criteria defined CR and PR the same as Macdonald criteria with the following additions: CR - improved non enhancing T2/FLAIR lesions; PR - no progression of non-measurable disease, stable or improved non enhancing FLAIR/T2 lesions. (NCT01474239)
Timeframe: Baseline until disease progression or death (baseline, 46 days after first administration of study drug, and thereafter every 56 days up to 691 days)

,
Interventionpercentage of participants (Number)
RANO EvaluationMacDonald Evaluation
Bevacizumab28.8128.81
Fotemustine9.386.25

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