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Survival analysis for patients with primary brain tumors treated with temozolomide


Al Musella's Comments: (This is his personal views and are not necessarily the views of the Musella Foundation!)



Website: http://www.asco.org/ac/1,1003,_12-002489-00_18-002003-00_19-00101103-00_29-00A,00.asp?cat=CNS+Tumors&parent=Central+Nervous+System+Tumors&returnpid=2325&SubCat_ID=4

Posted on: 06/14/2003

39th ASCO Annual Meeting • Chicago, IL • May 31-June 3, 2003 (Abstract No. 453)

Survival analysis for patients with primary brain tumors treated with temozolomide

B. E. Lally, J. Lacy, J. M. Piepmeier, J. M. Baehring, D. B. Fischer, J. P. S. Knisely

Yale University - School of Medicine, New Haven, CT

Purpose: Temozolomide(TEM) is a novel alkylating agent that has shown promising results when utilized in management of high-grade gliomas. We retrospectively reviewed our experience with TEM to determine if a survival benefit was associated with its use in patients with anaplastic astrocytomas (AA) and glioblastoma multiforme (GBM).

Methods: Between 3/1999 and 8/2002, 59 consecutive adult patients with high-grade gliomas were treated at our institution with radiotherapy. Twenty patients started treatment with adjuvant TEM given either concurrently with radiotherapy (75 mg/m^2 every day) and post radiotherapy (200 mg/m^2 daily for 5 days, q4 weeks), or post radiotherapy alone (200 mg/m^2 daily for 5 days, q4 weeks).

Thirty-five patients started treatment with adjuvant BCNU or PCV chemotherapy and 4 patients did not receive any adjuvant chemotherapy. Of these patients, 20 never received TEM while 19 subsequently were treated with TEM at the time of progression (200 mg/m^2 daily for 5 days, q4 weeks, but reduced to 150 mg/m^2 if prior nitrosourea therapy given). The primary endpoint was overall survival.

Results: Of the patients who received TEM as an adjuvant therapy or for progression (n = 39), 29 patients had GBM and 10 had AA. The median age of patients receiving TEM was 54 years (range 24-80 years). Of the patients who did not receive TEM (n=20), 13 had GBM and 7 had AA. The median age of patients not receiving TEM was 56 years (range 24-72 years). One of the patients who originally did not receive adjuvant chemotherapy was treated with TEM for progression.

The median survival for patients receiving TEM, either as an adjuvant therapy or for progression, was 17.8 months, while the median survival for patients not receiving TEM was 6.4 months (p=0.01).

Conclusions: This retrospective analysis suggests that the use of TEM in the management of patients with high-grade gliomas may be associated with an increase in survival.

Phase III trials are necessary to verify this observation.

© Copyright 2003 American Society of Clinical Oncology All rights reserved worldwide Source: http://www.asco.org/ac/1,1003,_12-002489-00_18-002003-00_19-00101103-00_29-00A,00.asp?cat=CNS+Tumors&parent= Central+Nervous+System+Tumors&returnpid=2325&SubCat_ID=4



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