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Temozolomide for the treatment of brain
metastases associated with metastatic melanoma: a phase II study
Agarwala SS, Kirkwood JM, Gore M, Dreno B, Thatcher N, Czarnetski B, Atkins
M, Buzaid A, Skarlos D, Rankin EM
Division of Hematology Oncology, University of Pittsburgh Medical
Center Pavilion, 5150 Centre Ave, Pittsburgh, PA 15232, USA. agarwalass@msx.upmc.edu
Purpose.
Temozolomide is
a well-tolerated oral alkylating agent with activity in the CNS.
A multicenter, open-label, phase II study was conducted to assess the safety and
efficacy of temozolomide in patients with brain metastases from metastatic
melanoma (MM) who did not require immediate radiotherapy.
Patients and Methods.
Eligible patients had histologically confirmed MM to the brain, and no prior
radiotherapy or radiosurgery for brain metastases.
Previously untreated patients received temozolomide at 200 mg/m(2)/d x 5 days;
previously treated patients received 150 mg/m(2)/d x 5 days every 28 days.
Treatment continued for 1 year or until disease progression or unacceptable
toxicity.
Results.
Of 151 patients
enrolled, 117 had received no prior systemic chemotherapy, and 34 had received
prior chemotherapy for MM.
Among previously untreated patients, 25% had more than four brain lesions, eight
(7%) achieved an objective response (one complete and seven partial), and 34
(29%) had stable disease in brain metastases.
Median overall survival was 3.5 months.
Among previously treated patients, 21% had more than four brain lesions, one had
a partial response, and six (18%) had stable disease in brain metastases.
Median overall survival was 2.2 months.
Temozolomide was well tolerated, with four (3%) patients discontinuing because
of adverse events.
Grade 3/4 hematologic toxicities included thrombocytopenia (3%), neutropenia
(2%), and leukopenia (1%).
Headache (9%) and vomiting (8%) were the most common nonhematologic grade 3/4
adverse events.
Conclusion.
Temozolomide
was well tolerated and demonstrated activity in the treatment of brain
metastases from MM.
Further evaluation of temozolomide combination therapy is warranted.
PMID: 15169796 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15169796
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