Efficacy and Safety of Plerixafor in High-grade Glioma: A Systematic Review
Omar Khaled Abdelsalam1, Asmaa Alnajjar2, Yusra Arafeh3, Mohamed Ahmed Zanaty4, Menna Mohamed Sarhan5, Khalid Omar Albataineh6, Mohamed wagdy7, Khaled M.H Mohamed8
1Faculty of Medicine, New Mansoura University, New Mansoura, Egypt, 2Faculty of Medicine Al-Azhar University, Gaza, Palestine, 3Faculty of Medicine, Jordan University of Science and Technology, 4Faculty of medicine, South Valley University, Qena, Egypt, 5Faculty of medicine, Zagazig university, Zagazig, Egypt, 6Faculty of Medicine, Al-Balqa Applied University, Al-Salt, Jordan, 7Modern university for technology and information, Cairo, Egypt, 8Visiting scholar, Pharmaceutical Sciences Department, College of Health and Human Sciences, North Dakota State University, Fargo, ND, USA
Objective:
This systematic review aims to evaluate the efficacy and safety of plerixafor in patients with high-grade glioma, focusing on its effects on overall survival, progression-free survival, and treatment-related adverse events.
Background:
High-grade gliomas are tumors of glial cells of the central nervous system. They are frequently leading to progressive disability and leading to death. CXCR4, a seven-domain G-protein coupled transmembrane receptor, has a role in cancer cell invasion and dissemination. Its activation promotes tumor cell proliferation and inhibits cell apoptosis. Plerixafor is an FDA-approved CXCR4 inhibitor; it increases apoptosis in high-grade gliomas by 2.7 times.
Design/Methods:
We searched Medline via PubMed, Cochrane Library, Scopus, Web of Science, and clinicaltrials.gov for randomized clinical trials and non-randomized clinical trials that assess the efficacy and safety of plerixafor in patients with high-grade glioma. The outcomes were overall survival (OS), progression-free survival (PFS), quality of life measures, and adverse events (AEs). This systematic review was conducted according to the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines.
Results:
Our study includes two non-randomized clinical trials with 55 patients with Grade IV glioma or glioblastoma. Results showed that the median overall survival (OS) in patients receiving plerixafor after macrophage exclusion therapy was 21.3 months. In the non-surgical phase 1 cohort of plerixafor and bevacizumab patients, the median overall survival was 7.11 months (95% CI, 5.6–9.2). In the three-phase 2 patients who received Plerixafor before surgery, OS was 1.78, 8, and 10.3 months, respectively. No serious adverse events were reported other than these.
Conclusions:
Plerixafor showed promising enhancement of the overall survival rates of patients with high-grade glioma with limited serious adverse events. However, future studies with large sample sizes and RCT design are necessary to evaluate its full potential efficacy and safety in HGG.
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