Oncology Medical News about Glioblastoma, Temozolomide, Methyltransferase

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Randomized phase II trial of chemoradiotherapy followed by either dose-dense or metronomic temozolomide for newly diagnosed glioblastoma
Journal of Clinical Oncology, 08/10/09

Clarke JL et al. – Phase II study reports that both dose-dense and metronomic temozolomide regimens were well tolerated with modest toxicity in the adjuvant treatment of newly diagnosed glioblastoma (GBM). The dose-dense regimen appears promising, with 1-yr survival of 80%.

Methods

An evaluation of 2 different temozolomide regimens in the adjuvant treatment of newly diagnosed GBM
Adult pts, randomly assigned to receive standard radiotherapy with concurrent daily temozolomide followed by 6 adjuvant cycles of either:
- Dose-dense (150 mg/m2 d1 to 7 and 15 to 21) or
- Metronomic (50 mg/m2 continuous daily) temozolomide
Maintenance doses of 13-cis-retinoic acid were then administered until tumor progression
Primary end point was overall survival (OS) at 1 yr
Tumor tissue was assayed to determine O6-methylguanine–DNA methyltransferase (MGMT) promoter methylation status

Results

85 pts; 42 randomly assigned to dose-dense, and 43 to metronomic temozolomide
1-year survival rate was 80% for the dose-dense arm and 69% for the metronomic arm
Median OS was 17.1 mo and 15.1 mo, respectively
Most common toxicities were myelosuppression (leukopenia, neutropenia, and thrombocytopenia), and elevated liver enzymes
Pseudoprogression was observed in 37% of assessable pts and may have had an impact on estimates of progression-free survival

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Current developments in the radiotherapy approach to elderly and frail patients with glioblastoma multiforme
Expert Review of Anticancer Therapy, 11/12/09 Relevance Score: 66%

Prognostic value of O6-methylguanine-DNA methyltransferase status in glioblastoma patients, assessed by five different methods
Journal of Neuro-Oncology, 10/28/09 Relevance Score: 65%

Six year survival after prolonged temozolomide treatment in a 30 year old patient with glioblastoma
Acta Neurologica Belgica, 10/21/09 Relevance Score: 65%

NOA-04 randomized phase III trial of sequential radiochemotherapy of anaplastic glioma with procarbazine, lomustine, and vincristine or temozolomide
Journal of Clinical Oncology, 11/12/09 Relevance Score: 64%

Efficacy of temozolomide as adjuvant chemotherapy after postsurgical radiotherapy alone for glioblastomas
Clinical Neurology and Neurosurgery, 10/16/09 Relevance Score: 64%