lomustine / Generic mfg. - LARVOL DELTA

Checkpoint inhibitors improve progression free survival after autologous transplant despite poorer pre-transplant response (ASH 2025) - "Introduction The checkpoint inhibitors (CI) nivolumab and pembrolizumab which target PD1 are established treatments for relapsed/refractory classic Hodgkin Lymphoma (cHL)...44 received brentuximab vedotin (BV)...All patients were conditioned with LEAM (lomustine, etoposide, cytarabine, melphalan)...CI treatment prior to ASCT may alter cHL disease biology leading to increased sensitization to subsequent high dose cytotoxic chemotherapy although more exploratory data assessing the mechanism is needed. We are planning a multi-centre analysis to investigate further."

Checkpoint inhibition • Pre-transplantation • Cardiovascular • Classical Hodgkin Lymphoma • Diabetes • Gastroenterology • Gastrointestinal Disorder • Hematological Malignancies • Hodgkin Lymphoma • Immunology • Lymphoma • Metabolic Disorders • Oncology • Pneumonia • Transplantation

Treatment strategies and innovation for recurrent high-grade glioma. (PubMed, J Neurooncol) - "Despite poor overall outcomes, incremental progress across targeted, immune, and delivery-based approaches supports a patient centered strategy emphasizing clinical-trial enrollment, molecular profiling and symptom focused care."

IO biomarker • Journal • Review • Brain Cancer • Diffuse Midline Glioma • Glioblastoma • Glioma • High Grade Glioma • Oncology • Solid Tumor • BRAF • NTRK

Comparing Isocitrate Dehydrogenase Inhibitors with Procarbazine, Lomustine, and Vincristine Chemotherapy for Oligodendrogliomas. (PubMed, Cancers (Basel)) - "IDH inhibitors such as vorasidenib have demonstrated promising efficacy and more favorable tolerability profiles, but a paucity of comparative data across therapeutic classes limits optimal treatment decision-making. Prospective head-to-head trials are essential for defining the optimal therapeutic sequence in this evolving treatment landscape. In the interim, we provide a recommend approach for current use."

Journal • Review • Brain Cancer • Glioma • Hematological Disorders • Oligodendroglioma • Oncology • Solid Tumor

An atlas of ex vivo drug sensitivity profiles in 666 clinical glioblastoma samples revealed distinct survival-associated networks (SNO 2025) - P=N/A | "Eleven drugs were tested, including DNA-damaging agents (lomustine, carboplatin, temozolomide, procarbazine, irinotecan, etoposide) and targeted agents (abemaciclib, dabrafenib, osimertinib, rucaparib, trametinib). Longitudinal sampling revealed dynamic changes in drug sensitivity, reflecting evolutionary tumor biology. This ex vivo drug sensitivity atlas reveals distinct, non-random survival-associated clustering patterns that reflect underlying glioblastoma cellular physiologies and may inform future clinical trial designs."

Preclinical • Brain Cancer • Glioblastoma • Glioma • Solid Tumor

Assessment of 18F-FET PET-based response to bevacizumab-based regimens in patients with glioblastoma at relapse using the PET RANO 1.0 criteria (SNO 2025) - "All patients (i) received bevacizumab in combination with a second agent (irinotecan, lomustine, or nivolumab), (ii) underwent MRI- and O-(2-[18F]fluoroethyl)-L-tyrosine (FET) PET imaging at baseline and at a median time of 8 weeks (range, 4-12 weeks) after treatment initiation, and (iii) had available PET-derived parameters, i.e., metabolic tumor volume (MTV), maximum and mean tumor-to-brain ratios (TBRmax and TBRmean). PET RANO 1.0 criteria appear to be effective in predicting response to bevacizumab-based therapy in glioblastomas at relapse."

Clinical • Brain Cancer • Glioblastoma • Solid Tumor

Identifying common transcriptional mechanisms in treatment-resistant glioma. (SNO 2025) - "Background: Glioma, the most common primary brain tumor, shows poor prognosis and resistance to first-line therapies, like temozolomide (TMZ), lomustine (LOM) and panobinostat-marizomib (PM), complicating treatment and diminishing disease-free survival. RNA-sequencing identified common genes linked to TMZ, LOM, and PM chemoresistance, revealing key genetic networks involved in acquiring and maintaining drug resistance. Targeting these pathways, along with epigenetic silencing and/or combinatorial therapies, may resensitize chemoresistant cells and allow for effective treatment of glioma."

Brain Cancer • Glioma • High Grade Glioma • Solid Tumor • ERBB4 • FOXA1 • PDGFRA • SOX2

Scalable Tracking of Symptoms in the Electronic Health Record using Large Language Models in Patients with Central Nervous System Cancers Undergoing Therapy (SNO 2025) - "We applied the LLM to an external dataset of 51,541 notes representing 1,642 patients seen in neuro-oncology clinic (1/2018 to 12/2023) to obtain real-world symptom prevalence for temozolomide, bevacizumab, lomustine, immune checkpoint inhibitors (ICI), and methotrexate. In conclusion, LLMs offer the ability to scale symptom extraction from health records, which is crucial to understand symptom burden and power symptom-related interventions and studies in real-world patient cohorts."

Clinical • Brain Cancer • CNS Tumor • Constipation • Gastroenterology • Gastrointestinal Disorder • Mood Disorders • Oncology

A rare case of recurrent astroblastoma: a 5-year follow up of treatment challenges and strategies to achieve local tumor control (SNO 2025) - "As gross total excision was not achieved, he received postoperative radiotherapy (54Gy via VMAT) and 12 months of adjuvant temozolomide (150 mg/m² on a 5/28 day schedule)...He was subsequently treated with six cycles of Lomustine administered every six weeks and bimonthly bevacizumab infusions...This case highlights evolving treatment approaches—including the use of an Ommaya reservoir, radiotherapy, adjuvant chemotherapy, and targeted therapy—as viable options for local tumor control following subtotal resection. It underscores the urgent need for collaborative research to improve outcomes for patients with astroblastoma."

Clinical • Glioma • Oncology • Solid Tumor

High-Grade Astrocytoma with Piloid Features: An institutional experience (SNO 2025) - "Systemic therapies were administered in 5/8 (lomustine, bevacizumab, pembrolizumab, temozolomide, trametinib, tovorafenib). While the optimal management of this newly recognized entity has yet to be established, our cohort demonstrates a clinical behavior consistent with CNS WHO grade 3, aligning with current WHO interpretations."

Clinical • Astrocytoma • Brain Cancer • Glioblastoma • Oncology • Solid Tumor • ATRX • BRAF • CDKN2A • CDKN2B • FGFR1 • KIAA1549 • NF1 • NTRK2

Long-Term Disease Control of Lynch Syndrome-Associated Thalamic Glioblastoma With Immunotherapy: A Case Study (SNO 2025) - "He began six weeks of concurrent chemoradiation with temozolomide (TMZ), followed by adjuvant TMZ...TMZ was discontinued, and he began treatment with bevacizumab and pembrolizumab every three weeks for 1.5 years...Four months later, he began lomustine and bevacizumab for six cycles (nine months)...He continues to work full-time as a software engineer and is doing well. This case highlights the potential efficacy of immunotherapy and TMZ avoidance, which could reduce hypermutation and support long-term disease control of LS-associated thalamic GBM."

Case study • Clinical • IO biomarker • Tumor mutational burden • Brain Cancer • Colorectal Cancer • Endometrial Cancer • Genetic Disorders • Glioblastoma • Immunology • Microsatellite Instability • Solid Tumor • ATRX • MSH6 • MSI • TMB

Larotrectinib for NTRK amplification in glioblastoma: Case report (SNO 2025) - "He underwent complete resection of the dominant lesion followed by concurrent temozolomide with radiation and 6 cycles of adjuvant temozolomide as well as tumor treating fields...Larotrectinib was discontinued and third line treatment with lomustine and bevacizumab was initiated...Our patient with glioblastoma harboring NTRK2 gene amplification did not have response to larotrectinib. Larotrectinib has demonstrated efficacy in gliomas with NRTK fusions but may not have efficacy in gliomas with NRTK amplifications."

Case report • Clinical • Brain Cancer • CNS Tumor • Esophageal Cancer • Glioblastoma • Glioma • High Grade Glioma • Solid Tumor • MGMT • NTRK • NTRK1 • NTRK2

Patterns of care and clinical outcomes of patients with IDH-mutant high-grade glioma in the United States from 2014-2023: a real-world analysis of the Tempus Lens database (SNO 2025) - "The most common treatment options administered at recurrence for astrocytoma were: re-treatment with temozolomide (13, 20%), bevacizumab (9, 14%), with lomustine, re-irradiation therapy, clinical trial and IDH inhibitors as additional less common alternatives. At recurrence, oligodendrogliomas were most frequently treated with bevacizumab (5, 36%), procarbazine and lomustine (3, 21%), or PCV (2, 14%). Additional findings, including molecular heterogeneity and survival data will be presented at the meeting. IDHmHGG represents a heterogeneous group of tumors with no clear standard-of-care upon recurrence after initial treatment."

Clinical • Clinical data • Real-world • Real-world evidence • Anaplastic Astrocytoma • Astrocytoma • Brain Cancer • Glioma • High Grade Glioma • Oligodendroglioma • Solid Tumor

Latest developments in GBM drug combination therapies for primary and recurrent GBM (SNO 2025) - "Current standard of care therapy including maximal surgical resection followed by temozolomide (TMZ) chemotherapy and radiation has only modestly extended survival rates...Of 147 eligible studies, TMZ, bevacizumab, and lomustine were the most frequently applied drugs in combination, presenting in 106 (72.1%), 43 (29.3%), 16 (10.9%) of studies, respectively...Conventional treatment standards have failed to significantly improve clinical outcomes. However, the combination of drug regimens along with SMIs has shown promising results that may guide future research efforts in treating this aggressive cancer."

Combination therapy • Brain Cancer • Glioblastoma • Hypertension • Solid Tumor • Thrombocytopenia

High-Grade Astrocytoma with Piloid Features: An institutional experience (WFNOS 2025) - "Systemic therapies were administered in 5/8 (lomustine, bevacizumab, pembrolizumab, temozolomide, trametinib, tovorafenib). While the optimal management of this newly recognized entity has yet to be established, our cohort demonstrates a clinical behavior consistent with CNS WHO grade 3, aligning with current WHO interpretations."

Clinical • Astrocytoma • Brain Cancer • Glioblastoma • Glioma • Oncology • Solid Tumor • ATRX • BRAF • CDKN2A • CDKN2B • FGFR1 • KIAA1549 • NF1 • NTRK2

Randomized phase 2 clinical trial of repeated intratumoral and cervical perilymphatic injections (CPLIs) of lerapolturev vs. lomustine in recurrent glioblastoma (rGBM): safety lead-in results (SNO 2025) - P1, P2 | "Repeated lerapolturev CED infusions into residual non-enhancing disease post-resection shows an acceptable toxicity profile. Safety and efficacy will be updated."

Clinical • P2 data • Brain Cancer • Cervical Cancer • CNS Disorders • Cognitive Disorders • Glioblastoma • Glioma • Oncology • Solid Tumor • CD8

Single institution experience with romiplostim for chemotherapy-induced thrombocytopenia in gliomas (SNO 2025) - "Background: Cytotoxic chemotherapy such as temozolomide, lomustine, procarbazine and platinum agents are the mainstay of glioma treatment. This single institution review provides evidence for the use of romiplostim to treat CIT in patients with glioma previously treated with temozolomide with no documented adverse events. Further studies are needed to examine if higher doses of romiplostim may be required to prevent CIT and continue chemotherapy without dose reduction."

Clinical • Brain Cancer • Glioma • Hematological Disorders • Solid Tumor • Thrombocytopenia • Thrombosis

A pilot clinical trial to determine the safety and feasibility of dietary methionine restriction in five healthy adult volunteers (The METeor study) (SNO 2025) - "Based on the half-life of the cytotoxic metabolites of lomustine, a 7-to-10-day period of methionine depletion should be sufficient to impair the metabolism of glioblastoma cells during their exposure to lomustine and might enhance its effectiveness. If successful, this pilot trial will lead to a phase 2 trial combining the diet with lomustine chemotherapy for recurrent glioblastoma patients."

Clinical • Brain Cancer • Glioblastoma • Glioma • Solid Tumor

Primary results of the randomized clinical trial of Berubicin vs Lomustine in patients with glioblastoma after failure of primary therapy: Data analysis and future possibilities (SNO 2025) - "Anthracyclines are characteristically used in combination for systemic therapy (e.g. leukemia, lymphoma, certain breast cancers), so there is promise that combination therapy will be the next pertinent approach to treatment of GBM. Evaluation of activity against a range of pediatric brain tumors is being pursued and preliminary results will be presented at the time of the conference."

Clinical • Brain Cancer • Breast Cancer • Glioblastoma • Hematological Malignancies • Leukemia • Lymphoma • Solid Tumor • MGMT

Synchronous Bilateral IDH1-Mutant Diffuse Gliomas in a Young Female with Germline PMS1Deletion: A Rare Case Suggestive of Lynch Syndrome Variant (SNO 2025) - "She completed adjuvant radiotherapy to both lesions and initiated lomustine chemotherapy...This case represents an exceptionally rare instance of multicentric, IDH1-mutant gliomas in a young adult with a germline PMS1 deletion. While PMS1 is not a classical LS gene, this finding suggests a possible pathogenic link. The case underscores the importance of integrated molecular diagnostics and germline testing in young patients with atypical glioma presentations and potential hereditary cancer syndromes."

Clinical • Astrocytoma • Brain Cancer • CNS Disorders • CNS Tumor • Colon Cancer • Colorectal Cancer • Epilepsy • Genetic Disorders • Glioma • Solid Tumor • ATRX • ERCC2 • IDH1 • MLH1 • MSH2 • MSH6 • PMS1 • PMS2 • TP53 • TSC2

Updated results of Phase 3 STELLAR trial: Eflornithine improves overall survival and blinded independent central review determined progression free survival in patients with recurrent WHO 2021 grade 3 IDH-mutant astrocytoma (SNO 2025) - "BACKGROUND: STELLAR was a phase III randomized, open-label trial of eflornithine (ornithine decarboxylase inhibitor) with lomustine versus lomustine alone in patients with recurrent anaplastic astrocytoma (AA). The clinically meaningful OS and PFS benefits observed with eflornithine in the molecularly defined 2021 WHO CNS grade 3 astrocytomas is further confirmed and expanded based on additional molecular classification and BICR of PFS."

Clinical • P3 data • Review • Anaplastic Astrocytoma • Astrocytoma • Brain Cancer • Glioblastoma • Oncology • Solid Tumor • CDKN2A • CDKN2B

Pharmacoscopy-guided discovery of vortioxetine as a repurposable neuroactive therapeutic for glioblastoma (SNO 2025) - "In orthotopic glioblastoma mouse models, vortioxetine showed consistent survival benefit across five independent preclinical trials, while combination therapy of vortioxetine with temozolomide or lomustine led to a 25–30% extension in overall survival compared to either agent alone.Here we used pharmacoscopy to rapidly and scalably profile patient tumors at single-cell resolution, demonstrating its clinical utility for personalized neuro-oncology. The functional relevance of this imaging-based precision medicine platform was confirmed by its concordance with temozolomide sensitivity and established prognostic markers such as MGMT status. Bridging neuroscience and oncology, our research advances a framework for targeting glioblastoma based on its neural etiology and identifies vortioxetine as promising repurposable therapeutic."

Brain Cancer • Glioblastoma • Solid Tumor

Prognostic relevance of preoperative FET PET in patients with newly diagnosed glioblastoma (SNO 2025) - "BACKGROUND: The present study investigated the prognostic relevance of O-(2-[18F]fluoroethyl)-L-tyrosine (FET) PET parameters in newly diagnosed IDH-wildtype glioblastoma. Fifty patients with newly diagnosed and histomolecularly characterized glioblastoma according to the WHO 2021 classification who had undergone FET PET imaging prior to diagnostic biopsy or surgery and subsequent postoperative radiotherapy with concomitant and adjuvant temozolomide (n=36) or temozolomide plus lomustine (n=14) were retrospectively analyzed. These data support the integration of the FET PET tumor volume as prognostic biomarker in glioblastoma risk stratification. Further studies with larger datasets are needed to substantiate our findings."

Clinical • Brain Cancer • Glioblastoma • Solid Tumor • MGMT

Randomized phase 2 clinical trial of repeated intratumoral and cervical perilymphatic injections (CPLIs) of lerapolturev vs. lomustine in recurrent glioblastoma (rGBM): safety lead-in results (SNO 2025) - P1, P2 | "Repeated lerapolturev CED infusions into residual non-enhancing disease post-resection shows an acceptable toxicity profile. Safety and efficacy will be updated."

Clinical • P2 data • Brain Cancer • Cervical Cancer • CNS Disorders • Cognitive Disorders • Glioblastoma • Glioma • Oncology • Solid Tumor • CD8

Response to next interventions after treatment with off-label ivosidenib in patients with mutant IDH low grade glioma (SNO 2025) - "Prior therapies included maximal safe resection (n=7), temozolomide (n=5), and lomustine (n=1); none had received prior radiation therapy (RT). In this early real-world cohort, most patients with mIDH LGG achieved clinical and radiographic stability after progression on ivosidenib using next-line chemotherapy and RT. These findings support the feasibility of cytotoxic strategies following mIDH inhibition."

Clinical • Astrocytoma • Brain Cancer • Glioma • Oligodendroglioma • Solid Tumor

Sonobird: A phase 3 trial of blood-brain-barrier (BBB) opening with the SonoCloud-9 in recurrent glioblastoma patients receiving IV carboplatin (SNO 2025) - P1/2, P3 | "The ongoing pivotal trial randomizes patients who are amenable to tumor resection to either resection with SC9 implantation followed by sonication + carboplatin (AUC 5 q3 weeks) or resection followed by temozolomide or lomustine without BBB opening. The ongoing pivotal trial is recruiting and estimated to complete enrollment by the end of 2026. This trial is supported by Carthera."

Clinical • P3 data • Brain Cancer • Glioblastoma • Solid Tumor