|
|
Temozolomide in the treatment of recurrent
malignant glioma
Chang SM, Theodosopoulos P, Lamborn K, Malec M, Rabbitt J, Page M, Prados MD
Department of Neurological Surgery, University of California-San
Francisco, San Francisco, California 94143, USA. changs@neurosurg.ucsf.edu
Background. Options for chemotherapy at the time of recurrence in
patients with malignant glioma are limited.
The authors describe the efficacy and safety results of their institution's
open-label, compassionate-use protocol of temozolomide for patients with
recurrent malignant glioma.
Methods. Patients with recurrent malignant glioma at any time during
recurrence were treated with oral temozolomide at a dose of 150 mg/m2 per day on
a 5-day schedule every 28 days.
If this dose was tolerated, then escalation to 200 mg/m2 was allowed.
Clinical evaluations and assessments of tumor response were performed every 2
months.
All patients or their surrogates signed approved Institutional Review Board
consent forms.
Results. Among 213 patients who were treated, 33% had Grade 3 tumors,
and 67% had Grade 4 tumors.
The overall objective response rate was 16% in both of these patient groups; and
an additional 51% and 30% of patients with Grade 3 and Grade 4 tumors,
respectively, had stable disease as their best response.
The 6-month progression-free survival rates were 41% and 18% for patients with
Grade 3 and Grade 4 tumors, respectively.
The median survival was 49 weeks for patients with Grade 3 tumors and 32 weeks
for patients with Grade 4 tumors.
The major toxicity was hematologic toxicity.
In multivariate analysis, the Karnofsky performance score was a significant
predictor of survival for patients with Grade 4 tumors.
Conclusions. Temozolomide was well tolerated in patients with
recurrent malignant glioma and had modest efficacy, even at the time of multiple
recurrences.
Copyright 2003 American Cancer Society.
PMID: 14745879 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14745879
|
