{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T23:21:42Z","timestamp":1787613702056,"version":"build-2736575974"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:00:00Z","timestamp":1785456000000},"content-version":"vor","delay-in-days":211,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite recent advances, survival in patients with glioblastoma remains poor. Outside clinical trials, lomustine is commonly considered standard of care in recurrent disease. However, comparative data between lomustine and other chemotherapy regimens are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective multicenter cohort study including patients from seven certified neuro-oncology centers in Germany to compare lomustine monotherapy with combination therapy using lomustine and procarbazine in first recurrence of glioblastoma. Propensity score matching was applied to obtain comparable groups based on sex, age, extent of resection at primary diagnosis, Karnofsky performance status at the start of recurrence therapy, and MGMT promoter methylation status. Post-recurrence survival (PRS) and progression-free survival (PFS) were analyzed using Kaplan-Meier estimation and multivariable Cox regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy-seven patients were matched in each treatment group. PRS was comparable, with a median of 11.6 months for lomustine monotherapy and 10.0 months for lomustine plus procarbazine (log-rank test, P\u2009=\u2009.120). Multivariable Cox regression showed no significant difference (HR 1.33, 95% CI, 0.93-1.90, P\u2009=\u2009.123). PFS was shorter in patients receiving combination therapy compared to monotherapy (3.7 vs. 5.1 months, log-rank test, P\u2009=\u2009.042). Multivariable Cox regression did not reveal significant differences (HR 1.31, 95% CI, 0.90-1.90, P\u2009=\u2009.166).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our data indicates that potential additive toxicity by intensified combination chemotherapy should be avoided due to lack of efficacy compared to lomustine monotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/noajnl\/vdag197","type":"journal-article","created":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T11:41:18Z","timestamp":1785498078000},"source":"Crossref","is-referenced-by-count":0,"title":["Lomustine with or without procarbazine in recurrent glioblastoma\u2014A propensity score matching analysis"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0590-8929","authenticated-orcid":false,"given":"Tareq","family":"Haedenkamp","sequence":"first","affiliation":[{"name":"Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital , Regensburg,","place":["Germany"]},{"name":"Department of Neurology, Krankenhaus Barmherzige Br\u00fcder Regensburg , Regensburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Fischl","sequence":"additional","affiliation":[{"name":"Wilhelm Sander-NeuroOncology Unit, Regensburg University Hospital , Regensburg,","place":["Germany"]},{"name":"Department of Neurology, Regensburg University Hospital , Regensburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8610-9303","authenticated-orcid":false,"given":"Michael","family":"Gerken","sequence":"additional","affiliation":[{"name":"Center for Quality Assurance and Health Services Research, University of Regensburg , Regensburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Rothhammer-Hampl","sequence":"additional","affiliation":[{"name":"Department of Neuropathology, Regensburg University Hospital , Regensburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelie","family":"Fassbender","sequence":"additional","affiliation":[{"name":"Department of Neurology, Technical University of Munich , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Verena","family":"Klein","sequence":"additional","affiliation":[{"name":"Dr. Senckenberg Institute of Neurooncology, Frankfurt Cancer Institute (FCI) and University Cancer Center Frankfurt (UCT), Goethe University Frankfurt, University Hospital Frankfurt , Mainz,","place":["Germany"]},{"name":"German Cancer Consortium (DKTK), Partner Site Frankfurt , Mainz,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6186-3630","authenticated-orcid":false,"given":"Ilon","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology with Experimental Neurology, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Layer","sequence":"additional","affiliation":[{"name":"Department of Neurology with Experimental Neurology, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amani","family":"Suboh","sequence":"additional","affiliation":[{"name":"Department of Neurology with Experimental Neurology, Charit\u00e9 - Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt Universit\u00e4t zu Berlin , Berlin,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Luisa","family":"Luger","sequence":"additional","affiliation":[{"name":"Dr. Senckenberg Institute of Neurooncology, Frankfurt Cancer Institute (FCI) and University Cancer Center Frankfurt (UCT), Goethe University Frankfurt, University Hospital Frankfurt , Mainz,","place":["Germany"]},{"name":"German Cancer Consortium (DKTK), Partner Site Frankfurt , Mainz,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iris","family":"Mildenberger","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical Faculty Mannheim, MCTN, Heidelberg University , Mannheim,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5818-5392","authenticated-orcid":false,"given":"Johannes","family":"Weller","sequence":"additional","affiliation":[{"name":"Department of Neurooncology, Center for Neurology and Centre of Integrated Oncology, University Hospital Bonn, University of Bonn , Bonn,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0678-5852","authenticated-orcid":false,"given":"Sied","family":"Kebir","sequence":"additional","affiliation":[{"name":"Division of Clinical Neurooncology, Department of Neurology, Universit\u00e4tsklinikum Essen Klinik f\u00fcr Neurologie , Essen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Division of Clinical Neurooncology, Department of Neurology, Universit\u00e4tsklinikum 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Bogenhausen , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4695-2483","authenticated-orcid":false,"given":"Joachim P","family":"Steinbach","sequence":"additional","affiliation":[{"name":"Dr. Senckenberg Institute of Neurooncology, Frankfurt Cancer Institute (FCI) and University Cancer Center Frankfurt (UCT), Goethe University Frankfurt, University Hospital Frankfurt , Mainz,","place":["Germany"]},{"name":"German Cancer Consortium (DKTK), Partner Site Frankfurt , Mainz,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralf","family":"Linker","sequence":"additional","affiliation":[{"name":"Department of Neurology, Regensburg University Hospital , Regensburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus J","family":"Riemenschneider","sequence":"additional","affiliation":[{"name":"Department of Neuropathology, Regensburg 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