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One week on/one week off
regimen of temozolomide for recurrent glioblastoma: A phase II study
W. Wick, J. P. Steinbach, J. Schuth, J. Dichgans, M. Bamberg, M. Weller
University of Tübingen, Tübingen, Germany; ESSEX Oncology
Research, München, Germany
Background.
Median survival for patients with glioblastoma is 12
months.
Patients progressing after cytoreductive surgery, radiotherapy and
nitrosourea-based adjuvant chemotherapy experience a median survival of 4-6
months.
There is no standard treatment for recurrent malignant glioma.
Temozolomide has shown activity in phase II studies of malignant gliomas and a
phase III study of metastatic malignant melanoma.
It is generally administered orally at 200 mg/m2 body surface area in a five-day
every 28 days schedule.
Methods.
Twentyone patients with recurrent or progressive glioblastoma were
enrolled in a prospective, unicenter trial to determine whether a one week
on/one week off regimen of temozolomide is feasible and effective as a salvage
therapy.
Chemotherapy consisted of temozolomide at 150 mg/m2 on days 1 to 7 and days 15
to 21 of 28 days treatment cycles.
Results.
There was no specific treatment-related neurotoxicity, but 3 of 21 patients
(14%) had to discontinue chemotherapy because of WHO IV hematological
toxicity.
There were two partial responses (10%), 17 patients (81%) had stable disease
according to MacDonald criteria.
The median progression-free survival is 5 months, and the progression-free
survival rate at 6 months is 43%.
The median overall survival from diagnosis has not yet been reached, but will be
more than 16 months.
Conclusions.
The schedule used in the present study is a feasible and
effective treatment of recurrent glioblastoma.
Copyright 2004 American Society of Clinical Oncology All rights
reserved worldwide.
Source: http://www.asco.org/ac/1,1003,_12-002636-00_18-0026-00_19-00510,00.asp
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