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Temozolomide As Initial Treatment for Adults With Low-Grade
Oligodendrogliomas or Oligoastrocytomas and Correlation With
Chromosome 1p Deletions
K. Hoang-Xuan, L. Capelle, M.
Kujas, S. Taillibert, H. Duffau, J.
Lejeune, M. Polivka, E. Crinière, Y.
Marie, K. Mokhtari, A.F. Carpentier, F.
Laigle, J.M. Simon, P. Cornu, P.
Broët, M. Sanson, J.Y. Delattre
From the Fédération Neurologique Mazarin, Service
de Neurochirurgie, Laboratoire de Neuropathologie, and Service de
Radiothérapie, Groupe Hospitalier Pitié-Salpêtrière; Institut
National de la Santé et de la Recherche Médicale U495; Université
P. et M. Curie; Service d'Anatomopathologie, Hôpital Lariboisière,
Paris; and Unité de Biostatistique, INSERM U472, Villejuif, France.
Address reprint requests to K. Hoang-Xuan, MD, Fédération
Neurologique Mazarin and INSERM U495, Groupe Hospitalier Pitié-Salpêtrière,
47 Blvd de l'Hôpital, 75651 Paris Cedex 13, France; e-mail: khe.hoang-xuan@psl.ap-hop-paris.fr
Purpose. To determine the response rate of low-grade
oligodendroglial tumors (LGOT) to temozolomide (TMZ) as
initial treatment and to evaluate the predictive value of
chromosome 1p deletion on the radiologic response.
Patients and Methods. Adult patients with pathologically proven
LGOT with progressive disease on magnetic resonance imaging
(MRI) were eligible for the study.
TMZ was administered at
the starting dose of 200 mg/m2/d for 5 days,
repeated every 28 days.
Response was evaluated clinically
and by central review of MRIs.
Chromosome 1p and 19q
deletions were detected by the loss of heterozygosity technique.
Results. Sixty consecutive patients were included in the study.
At
the time of analysis, the median number of TMZ cycles
delivered was 11.
Clinically, 51% of patients improved,
particularly those with uncontrolled epilepsy.
The
objective radiologic response rate was 31% (17% partial
response and 14% minor response), whereas 61% of patients
had stable disease and 8% experienced disease progression.
The median time to maximum tumor response was 12 months
(range, 5 to 20 months).
Myelosuppression was the most
frequent side effect, with grade 3 to 4 toxicity in 8% of
patients.
Loss of chromosome 1p was associated with objective tumor
response (P < .004).
Conclusion. TMZ is well tolerated and provides a substantial rate
of response in LGOT.
Chromosome 1p loss is correlated with
radiographic response and could be a helpful marker for
guiding therapeutic decision making in LGOT.
© 2004 American Society of Clinical Oncology
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