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Salvage temozolomide for prior temozolomide responders
Author(s) -
Franceschi Enrico,
Omuro Antonio M. P.,
Lassman Andrew B.,
Demopoulos Alexis,
Nolan Craig,
Abrey Lauren E.
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21564
Subject(s) - medicine , temozolomide , anaplastic astrocytoma , salvage therapy , surgery , progressive disease , oncology , glioma , dacarbazine , cancer , retrospective cohort study , disease , chemotherapy , astrocytoma , cancer research
BACKGROUND Temozolomide (TMZ) often is used as adjuvant or first‐line therapy for patients with glioma. Because of potential hematologic complications, it usually is discontinued after 12–18 cycles, even in responders. Subsequent salvage therapies are reported to have limited efficacy at the time of disease recurrence. In the current study, the authors assessed the outcome and complications of reusing TMZ at the time of disease recurrence in patients who previously responded to treatment. METHODS A retrospective review of patients with recurrent/progressive glioma who had a history of response to TMZ and were treated with the same agent at the time of disease recurrence was conducted. RESULTS Fourteen patients were identified (8 men and 6 women). The median age of the patients was 56 years (range, 25–67 yrs) at the time of diagnosis; 9 patients had glioblastoma, 3 had anaplastic astrocytoma, and 2 patients had low‐grade oligodendroglioma. No patient developed disease progression while receiving the initial TMZ treatment. At the time of the initial disease recurrence, 13 patients were readministered TMZ. One patient received TMZ at the time of second disease recurrence. All patients were assessed for radiographic response. Objective response or stable disease was achieved in 6 patients (43%; 95% confidence interval [95% CI], 21–67%) and the 6‐month progression‐free survival was 36% (95% CI, 16–61%). CONCLUSIONS TMZ was found to be well tolerated and effective in this setting, suggesting that repeat use of TMZ in previous responders warrants further investigation. Cancer 2005. © 2005 American Cancer Society.