Treatment > Temozolomide Clinical Trials  

Meeting Abstract

Efficacy and low toxicity of temozolomide in the treatment of primary brain tumors

Ilda Costa, Duarte Salgado, Teresa Pimentel, Joao Nunes, M Luz Quintal, Jose Bravo-Marques

Instituto Portugues Oncologia, Lisboa, Portugal

Our results with temozolomide treating 71 patients, 68 adults and 3 children since 1995 with reccurent primary central nervous system tumors are presented. 
They include 35 glioblastomas (GBM), 13 anaplastic astrocytomas (AA), 21 anaplastic oligodendrogliomas (AO) and mixed oligoastrocytomas (MOA), 1 brain stem glioma and 1 anaplastic ependymoma. 
All patients had surgery at initial presentation and underwent external radiotherapy, 48 also had chemotherapy with PCV combination or nitrosurea ( BCNU or CCNU ) either at initial presentation of first reccurence. 
Medium time to progression after temozolomide therapy was 4.6 months in GBM, 6.5 months in AA and 5.3 months in the oligo group. 
According to MacDonald criteria we found partial response in 20.5% of GBM, 50% of AA and 16.6% of AO and MOA, stable disease in 50% of GBM, 50% of AA, 61.1% of AO and MOA, and progressive disease in 29.4% of GBM, 22.2% of AO and MOA. 
Still, several patients are under treatment and unevaluable for best response to temozolomide. 
We have performed a total of 350 cycles of temozolomide chemotherapy, of which 303 were fully evaluable and found hematologic grade 3 and 4 toxicity in 4.9% of cycles, and grade 1 and 2 hematologic toxicity in 15.8%. 
We did not find any toxicities in other areas causing dose reduction. 
We conclude that temozolomide is safe, even in patients with previous chemotherapies, having a low toxicity profile and is a valuable drug in several types of reccurent primary brain tumors.

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