Dose dense 1 week on-1 week off temozolomide in recurrent glioma: a retrospective studyReport as inadecuate




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Journal of Neuro-Oncology

, Volume 108, Issue 1, pp 195–200

First Online: 07 March 2012Received: 18 November 2011Accepted: 15 February 2012

Abstract

Alternative temozolomide regimens have been proposed to overcome O-methylguanine-DNA methyltransferase mediated resistance. We investigated the efficacy and tolerability of 1 week on-1 week off temozolomide ddTMZ regimen in a cohort of patients treated with ddTMZ between 2005 and 2011 for the progression of a glioblastoma during or after chemo-radiation with temozolomide or a recurrence of another type of glioma after radiotherapy and at least one line of chemotherapy. Patients received ddTMZ at 100–150 mg-m-d days 1–7 and 15–21 in cycles of 28-days. All patients had a contrast enhancing lesion on MRI and the response was assessed by MRI using the RANO criteria; complete and partial responses were considered objective responses. Fifty-three patients were included. The median number of cycles of ddTMZ was 4 range 1–12. Eight patients discontinued chemotherapy because of toxicity. Two of 24 patients with a progressive glioblastoma had an objective response; progression free survival at 6 months PFS-6 in glioblastoma was 29%. Three of the 16 patients with a recurrent WHO grade 2 or 3 astrocytoma or oligodendroglioma or oligo-astrocytoma without combined 1p and 19q loss had an objective response and PFS-6 in these patients was 38%. Four out of the 12 evaluable patients with a recurrent WHO grade 2 or 3 oligodendroglioma or oligo-astrocytoma with combined 1p and 19q loss had an objective response; PFS-6 in these patients was 62%. This study indicates that ddTMZ is safe and effective in recurrent glioma, despite previous temozolomide and-or nitrosourea chemotherapy. Our data do not suggest superior efficacy of this schedule as compared to the standard day 1–5 every 4 weeks schedule.

KeywordsGlioma Glioblastoma Dose dense temozolomide 1p 19q Chemotherapy Brain tumors Astrocytoma Oligodendroglioma  Download fulltext PDF



Author: Walter Taal - Joyce M. W. Segers-van Rijn - Johan M. Kros - Irene van Heuvel - Carin C. D. van der Rijt - Jacoline E.

Source: https://link.springer.com/







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