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Role of temozolomide (TMZ) for brain relapsed tumors: preliminary results Use of temodar as sole chemotherapy agent showed positive results in pts who had already had surgery, radiotherapy and chemotherapy and had recurrence of tumor.

Posted on: 05/26/2002

Role of temozolomide (TMZ) for brain relapsed tumors: preliminary results

Antonio Santoro, Massimiliano Santoro, Luigi Maiorino, San Gennaro Hospital, Naples, Italy.

Background: Despite of new integrated approaches (surgery + radiotherapy and chemotherapy), the prognosis for patients affected by malignant brain tumors is still inauspicious. TMZ is a novel alkylant chemotherapeutic drug which has been shown to have antitumor activity in these particular case.

Purpose: to value the efficacy and toxicity of monochemotheraputical TMZ treatment in patients with brain tumors relapsed after surgical and radiotherapeutical treatment.

Methods: 18 patients (13 afflicted by glioblastoma and 5 by anaplastic astrocytoma) with a median age of 60 years and median performance status (ECOG) of 2, have been registered to the study. All the patients enrolled were treated with TMZ according to a weekly therapeutical scheme: 150 mg/m2/die for 5 consecutive days; the cycle has been repeated every 28 days x 6.

Results: 1 patient died for an heart failure. After 6 complete cycles, 3 patients achieved a complete response while 6 presented a partial response >50%. Besides, 4 stable diseases and 4 progression of disease have been registered. An acceptable systemic toxicity has been obtained. Grade 3 (WHO) neutropenia has been observed in 11 patients; at the end of the 4th cycle, 1 patient was afflicted by a grade IV neutropenia well controlled with Granulocyte Colony Stimulating Factor (rhu G-CSF) administration.

Conclusion: these preliminary data (median follow-up of 18 months), confirm that TMZ administered as a single chemotherapeutic agent showed a good efficacy and tolerability with a moderate toxicity in patients with brain relapsed tumors.
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