Journal of Neuro-Oncology

, Volume 89, Issue 2, pp 179–185

Temozolomide three weeks on and one week off as first line therapy for patients with recurrent or progressive low grade gliomas

  • A. Tosoni
  • E. Franceschi
  • M. Ermani
  • R. Bertorelle
  • L. Bonaldi
  • V. Blatt
  • Alba A. Brandes
Clinical-patient studies

DOI: 10.1007/s11060-008-9600-y

Cite this article as:
Tosoni, A., Franceschi, E., Ermani, M. et al. J Neurooncol (2008) 89: 179. doi:10.1007/s11060-008-9600-y

Abstract

Background: Patients with recurrent or progressive low grade gliomas survive for a decade or more following diagnosis, and may be at a higher risk for treatment-related complications, such as cognitive impairment from radiotherapy. Purpose: The aim of the present study was to determine in patients with progressive or recurrent low grade gliomas, the response rate and toxicity incurred by a continued schedule of temozolomide chemotherapy administered before radiation therapy, and to explore correlations between response and survival with 1p/19q deletions and MGMT promoter methylation status. Methods: Progressive radio and chemotherapy naïve low grade glioma patients with O6-methyl-guanine-DNA-methyl-tranferase (MGMT) promoter status evaluation were considered eligible. Chemotherapy cycles consisted of temozolomide 75 mg/m2/daily for 21 days every 28 days for 12 cycles. Results: A total of 30 patients (median age 45 [range: 24.2–68.6] years) with a median KPS of 90 (range 60–90) were accrued. The overall response rate was 30% (9 partial responses); 17 patients (56.7%) had disease stabilization. Conclusion: The prolonged temozolomide schedule considered in the present study is followed by a high response rate; toxicity is acceptable. Further randomized trials should therefore be conducted to confirm the efficacy of this regimen as first-line therapy in patients with progressive low grade glioma.

Keywords

Clinical trialsLow grade gliomas1p/19q deletionsMGMTProlonged temozolomide

Copyright information

© Springer Science+Business Media, LLC. 2008

Authors and Affiliations

  • A. Tosoni
    • 1
  • E. Franceschi
    • 1
  • M. Ermani
    • 2
  • R. Bertorelle
    • 3
  • L. Bonaldi
    • 3
  • V. Blatt
    • 4
  • Alba A. Brandes
    • 1
  1. 1.Department of Medical OncologyBellaria-Maggiore HospitalBolognaItaly
  2. 2.Department of Neurological SciencesAzienda Ospedale-UniversitàPadovaItaly
  3. 3.Servizio di Immunologia e Diagnostica Molecolare OncologicaIstituto Oncologico Veneto-IRCCSPadovaItaly
  4. 4.Research and Development UnitAzienda Ospedaliera di PadovaPadovaItaly