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Extensive Shrinkage and Long-term Stable Disease in a Teenage Female Patient With High-grade Glioma Treated With Temozolomide and Radiation in Combination With Oral Recombinant Methioninase and a Low-methionine Diet.
- Source :
-
In vivo (Athens, Greece) [In Vivo] 2024 May-Jun; Vol. 38 (3), pp. 1459-1464. - Publication Year :
- 2024
-
Abstract
- Background/aim: Gliomas are the most common and recalcitrant malignant primary brain tumors. All cancer types are addicted to methionine, which is a fundamental and general hallmark of cancer known as the Hoffman effect. Particularly glioma cells exhibit methionine addiction. Because of methionine addiction, [ <superscript>11</superscript> C]-methionine positron emission tomography (MET-PET) is widely used for glioma imaging in clinical practice, which can monitor the extent of methionine addiction. Methionine restriction including recombinant methioninase (rMETase) and a low-methionine diet, has shown high efficacy in preclinical models of gliomas, especially in combination with chemotherapy. The aim of the present study was to determine the efficacy of methionine restriction with oral rMETase (o-rMETase) and a low-methionine diet, combined with radiation and temozolomide (TMZ), on a teenage female patient with high-grade glioma.<br />Case Report: A 16-year-old girl was diagnosed with high-grade glioma. Magnetic resonance imaging (MRI) showed a left temporal-lobe tumor with compression to the left lateral ventricle and narrowing of sulci in the left temporal lobe. After the start of methionine restriction with o-rMETase and a low-methionine diet, along with TMZ combined with radiotherapy, the tumor size shrunk at least 60%, with improvement in the left lateral ventricle and sulci. The patient's condition remains stable for 19 months without severe adverse effects.<br />Conclusion: Methionine restriction consisting of o-rMETase and a low-methionine diet, in combination with radiation and TMZ as first-line chemotherapy, were highly effective in a patient with high-grade glioma.<br /> (Copyright © 2024, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
- Subjects :
- Humans
Female
Adolescent
Magnetic Resonance Imaging
Brain Neoplasms pathology
Brain Neoplasms drug therapy
Brain Neoplasms therapy
Treatment Outcome
Neoplasm Grading
Positron-Emission Tomography
Recombinant Proteins administration & dosage
Combined Modality Therapy
Glioma pathology
Glioma drug therapy
Glioma therapy
Carbon-Sulfur Lyases
Temozolomide administration & dosage
Temozolomide therapeutic use
Methionine administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1791-7549
- Volume :
- 38
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- In vivo (Athens, Greece)
- Publication Type :
- Academic Journal
- Accession number :
- 38688589
- Full Text :
- https://doi.org/10.21873/invivo.13591