Odette Cancer Centre and Sunnybrook Health Sciences Centre; Princess Margaret Hospital, Toronto; London Regional Cancer Program, London Health Sciences Centre, London, Ontario; Hôpital Notre-Dame; Royal Victoria Hospital, Montreal; Hôpital de l'Enfant-Jésus, Quebec City; Schering-Plough Canada, Kirkland, Quebec; Cross Cancer Institute, Edmonton; Tom Baker Cancer Center, Calgary, Alberta; Queen Elizabeth II Health Sciences Centre, Halifax, Nova Scotia; Cancer Care Manitoba, Winnipeg, Manitoba; and British Columbia Cancer Agency-Vancouver Cancer Centre, Vancouver, British Columbia, Canada.
J Clin Oncol. 2010 Mar 22.
Concomitant temozolomide (TMZ)/radiotherapy followed by adjuvant TMZ has increased survival in patients with glioblastoma multiforme (GBM). However, few options are effective for patients who experience treatment failure. We conducted a multicenter, phase II study to assess the efficacy and safety of continuous dose-intense TMZ for recurrent GBM.
A total of 116 of 120 patients were evaluable for efficacy. For patients with GBM, 6-month progression-free survival (PFS) was 23.9% (B1, 27.3%; B2, 7.4%; B3, 35.7%). One-year survival from time of study entry was 27.3%, 14.8%, and 28.6% for the B1, B2 and B3 groups, respectively. For patients with anaplastic glioma, 6-month PFS was 35.7%; 1-year survival was 60.7%. The most common grades 3 and 4 nonhematologic toxicities were nausea/vomiting (6.7%) and fatigue (5.8%). Grades 3 and 4 hematologic toxicities were uncommon.
Rechallenge with continuous dose-intense TMZ 50 mg/m(2)/d is a valuable therapeutic option for patients with recurrent GBM. Patients who experience progression during the first six cycles of conventional adjuvant TMZ therapy or after a treatment-free interval get the most benefit from therapy.
PMID: 20308655 [PubMed - as supplied by publisher] Source: National Library of Medicine.
