QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Home | Help | Feedback | Subscriptions | Archive | Search | Table of Contents

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (41) Citing Articles via Google Scholar Google Scholar Articles by Khan, R. B. Articles by Abrey, L. E. Search for Related Content PubMed PubMed Citation

A phase II study of extended low-dose temozolomide in recurrent malignant gliomas

Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021

³ Address correspondence and reprint requests to Lauren E. Abrey, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021.

Temozolomide is an effective agent in the treatment of recurrent malignant gliomas. The standard dosage is 150-200 mg/m² per day for 5 days in a 28-day cycle. A prior phase I study established a chronic daily temozolomide dose that significantly increased the total dose administered and suggested a superior response rate. In a prospective phase II trial, we treated 35 patients with recurrent malignant gliomas with temozolomide 75 mg/m² per day for 42 consecutive days in a 70-day cycle. Median age was 55 years (range, 27-73 years) and median Karnofsky performance score was 70 (range, 60-90). Twenty-eight (79%) patients had glioblastoma multiforme, 3 (9%) anaplastic astrocytoma, 2 (6%) anaplastic oligodendroglioma, and 2 (6%) anaplastic oligoastrocytoma. All but one had prior radiotherapy, and 27 had prior chemotherapy. There were 2 partial (anaplastic astrocytoma) and 3 minor (glioblastoma multiforme) radiographic responses; 17 patients had progressive disease at the end of the first cycle. In 55 cycles of temozolomide, there were 8 episodes of asymptomatic drug-related grade 3 toxicity: 6 lymphopenia, 1 neutropenia, and 1 thrombocytopenia. Median progression-free survival and overall survival were 2.5 and 8.7 months (2.3 and 7.7 months in glioblastoma multiforme patients). At 6 months, progression-free survival and overall survival rates were 27% and 67% (19% and 60% in glioblastoma multiforme). Quality of life scores did not change significantly during treatment. We conclude that the extended low-dose schedule of temozolomide is well tolerated in heavily pretreated patients; however, our results do not support an improved rate of response or survival.

This article has been cited by other articles:

				J.-x. Cheng, X. Zhang, and B.-L. Liu Health-related quality of life in patients with high-grade glioma Neuro-oncol, January 1, 2009; 11(1): 41 - 50. [Abstract] [Full Text] [PDF]

				W. Wick, M. Platten, and M. Weller New (alternative) temozolomide regimens for the treatment of glioma Neuro-oncol, January 1, 2009; 11(1): 69 - 79. [Abstract] [Full Text] [PDF]

				E. T. Wong, A. A. Brandes, and A. Tosoni Is protracted low-dose temozolomide feasible in glioma patients? Neurology, August 8, 2006; 67(3): 543 - 544. [Full Text] [PDF]

				J. P. Fruehauf, H. Brem, S. Brem, A. Sloan, G. Barger, W. Huang, and R. Parker In vitro Drug Response and Molecular Markers Associated with Drug Resistance in Malignant Gliomas Clin. Cancer Res., August 1, 2006; 12(15): 4523 - 4532. [Abstract] [Full Text] [PDF]

				I. Y. Eyupoglu, E. Hahnen, C. Trankle, N. E. Savaskan, F. A. Siebzehnrubl, R. Buslei, D. Lemke, W. Wick, R. Fahlbusch, and I. Blumcke Experimental therapy of malignant gliomas using the inhibitor of histone deacetylase MS-275 Mol. Cancer Ther., May 1, 2006; 5(5): 1248 - 1255. [Abstract] [Full Text] [PDF]

				A. Tosoni, G. Cavallo, M. Ermani, L. Scopece, E. Franceschi, C. Ghimenton, M. Gardiman, L. Pasetto, V. Blatt, and A. A. Brandes Is protracted low-dose temozolomide feasible in glioma patients? Neurology, February 14, 2006; 66(3): 427 - 429. [Abstract] [Full Text] [PDF]

				J. A. Quinn, A. Desjardins, J. Weingart, H. Brem, M. E. Dolan, S. M. Delaney, J. Vredenburgh, J. Rich, A. H. Friedman, D. A. Reardon, et al. Phase I Trial of Temozolomide Plus O6-Benzylguanine for Patients With Recurrent or Progressive Malignant Glioma J. Clin. Oncol., October 1, 2005; 23(28): 7178 - 7187. [Abstract] [Full Text] [PDF]

				M. C. Chamberlain, D. D. Tsao-Wei, and S. Groshen Temozolomide for treatment-resistant recurrent meningioma Neurology, April 13, 2004; 62(7): 1210 - 1212. [Abstract] [Full Text] [PDF]

				Y.B. Su, S. Sohn, S. E. Krown, P. O. Livingston, J. D. Wolchok, C. Quinn, L. Williams, T. Foster, K. A. Sepkowitz, and P. B. Chapman Selective CD4+ Lymphopenia in Melanoma Patients Treated With Temozolomide: A Toxicity With Therapeutic Implications J. Clin. Oncol., February 15, 2004; 22(4): 610 - 616. [Abstract] [Full Text] [PDF]

				S. L. Chua, M. A. Rosenthal, S. S. Wong, D. M. Ashley, A.-m. Woods, A. Dowling, and L. M. Cher Phase 2 study of temozolomide and Caelyx in patients with recurrent glioblastoma multiforme Neuro-oncol, January 1, 2004; 6(1): 38 - 43. [Abstract] [PDF]

				A. Pace, A. Vidiri, E. Galie, M. Carosi, S. Telera, A. M. Cianciulli, P. Canalini, D. Giannarelli, B. Jandolo, and C. M. Carapella Temozolomide chemotherapy for progressive low-grade glioma: clinical benefits and radiological response Ann. Onc., December 1, 2003; 14(12): 1722 - 1726. [Abstract] [Full Text] [PDF]