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Chemotherapy

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Book cover High-Grade Gliomas

Part of the book series: Current Clinical Oncology ((CCO))

Abstract

The role of systemic chemotherapy in high-grade gliomas (HGG) continues to evolve. The use of chemotherapy for central nervous system (CNS) malignancies poses specific challenges related to drug delivery and interactions with anticonvulsants. Chemotherapy has become standard in the adjuvant therapy of HGG. For patients with chemotherapy-sensitive subgroups of pure and mixed anaplastic oligodendrogliomas, chemotherapy represents the preferred initial therapy. Chemotherapy is often used for patients with recurrent HGG. The efficacy of chemotherapy for patients with HGG is likely to improve substantially with the advent of new drugs with novel mechanisms of action, markers to select patients likely to benefit from chemotherapy, new methods to enhance drug delivery, and strategies to circumvent drug resistance.

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References

  1. Muldoon LL, Pagel MA, Kroll RA, Roman-Goldstein S, Jones RS, Neuwelt EA. A physiological barrier distal to the anatomic blood-brain barrier in a model of trans vascular deliver. Am J Neuroradiol 1999;20:217–222.

    PubMed  CAS  Google Scholar 

  2. Ashby LS, Shapiro WR. Intra-arterial cisplatin plus oral etoposide for the treatment of recurrent malignant glioma: a phase II study. J Neurooncol 2001;51:67–86.

    Article  PubMed  CAS  Google Scholar 

  3. Mardor Y, Roth Y, Lidar Z, et al. Monitoring response to convection-enhanced taxol delivery in brain tumor patients using diffusion-weighted magnetic resonance imaging. Cancer Res 2001;61:4971–4973.

    PubMed  CAS  Google Scholar 

  4. Sheline GE, Wara WM, Smith V. Therapeutic irradiation and brain injury. Int J Radiat Oncol Biol Phys. 1980;6:1215–1228.

    PubMed  CAS  Google Scholar 

  5. Grossman SA, Wharam M, Sheidler V, et al. Phase II study of continuous infusion carmustine and cisplatin followed by cranial irradiation in adults with newly diagnosed high-grade astrocytoma. J Clin Oncol. 1997;15:2596–2603.

    PubMed  CAS  Google Scholar 

  6. Grossman SA, Sheidler VR, Gilbert MR. Decreased phenytoin levels in patients receiving chemotherapy. Am J Med. 1989;87:505–510.

    Article  PubMed  CAS  Google Scholar 

  7. Grossman SA, Hochberg F, Fisher J, et al. Increased 9-aminocamptothecin dose requirements in patients on anticonvulsants. N ABTT CNS Consortium. The New Approaches to Brain Tumor Therapy. Cancer Chemother Pharmacol. 1998;42:118–126.

    Article  PubMed  CAS  Google Scholar 

  8. Fetell MR, Grossman SA, Fisher JD, et al. Preirradiation paclitaxel in glioblastoma multiforme: efficacy, pharmacology, and drug interactions. New Approaches to Brain Tumor Therapy Central Nervous System Consortium. J Clin Oncol. 1997;15:3121–3128.

    PubMed  CAS  Google Scholar 

  9. McDonald DR, Cascino TL, Schold SC Jr, Cairncross JG. Response criteria for phase II studies of supratentoral malignant glioma. J Clin Oncol 1990;8:1277–1280.

    Google Scholar 

  10. Eagen RT, Scott M. Evaluation of prognostic factors in chemotherapy of recurrent brain tumors. J Clin Oncol. 1983;1:38–44.

    Google Scholar 

  11. Nelson DF, Nelson JS, Davis DR, Chang CH, Griffin TW, Pajak TF. Survival and prognosis of patients with astrocytoma with atypical or anaplastic features. J Neurooncol. 1985;3:99–103.

    Article  PubMed  CAS  Google Scholar 

  12. Curran WJ Jr, Scott CB, Horton J, et al. Recursive partitioning analysis of prognostic factors in three Radiation Therapy Oncology Group malignant glioma trials. J Natl Cancer Inst 1993; 85:704–710.

    Article  PubMed  Google Scholar 

  13. Byar DP Green SB, Strike TA, et al. Prognostic factors for malignant gliomas. In Walker MD (ed). Oncology of the nervous system. Boston. Marinus Nijhoff, 1983:379–395.

    Google Scholar 

  14. Walker MD, Alexander E Jr, Hunt WE, et al. Evaluation of BCNU and/or radiotherapy in the treatment of anaplastic gliomas. A cooperative clinical trial. J Neurosurg 1978;49:333–343.

    PubMed  CAS  Google Scholar 

  15. Walker MD, Green SB, Byar DP, et al. Randomized comparisons of radiotherapy and nitrosoureas for the treatment of malignant glioma after surgery. N Engl J Med 1980;303:1323–1329.

    Article  PubMed  CAS  Google Scholar 

  16. Stupp R, Mason WP, van den Bent MJ, et al. European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups; National Cancer Institute of Canada Clinical Trials Group. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005;352:987–96.

    Article  PubMed  CAS  Google Scholar 

  17. Green SB, Byar DP, Walker MD, et al. Comparisons of carmustine, procarbazine, and high-dose methylpred-nisolone as additions to surgery and radiotherapy for the treatment of malignant glioma. Cancer Treat Rep 1983;67:121–132.

    PubMed  CAS  Google Scholar 

  18. Shapiro WR, Green SB, Burger PC, et al. Randomized trial of three chemotherapy regimens and two radiotherapy regimens and two radiotherapy regimens in postoperative treatment of malignant glioma. Brain Tumor Cooperative Group Trial 8001. J Neurosurg 1989;71:1–9.

    PubMed  CAS  Google Scholar 

  19. Deutsch M, Green SB, Strike TA, et al. Results of a randomized trial comparing BCNU plus radiotherapy, streptozotocin plus radiotherapy, BCNU plus hyperfractionated radiotherapy, and BCNU following misonidazole plus radiotherapy in the postoperative treatment of malignant glioma. Int J Radiat Oncol Biol Phys 1989;16:1389–1396.

    PubMed  CAS  Google Scholar 

  20. Yung YK, Albright RE, Olson J, et al. A phase II study of temozolomide vs procarbazine in patients with glioblastoma at first relapse. Brit J Cancer 2000;83:588–593.

    Article  PubMed  CAS  Google Scholar 

  21. Westphal M, Hilt DC, Bortey E, et al. A phase 3 trial of local chemotherapy with biodegradable carmustine (BCNU) wafers (Gliadel wafers) in patients with primary malignant glioma. Neuro-oncol 2003;5:79–88.

    Article  PubMed  CAS  Google Scholar 

  22. Dhodapkar M, Rubin J, Reid JM, et al. Phase I trial of temozolomide (NSC 362856) in patients with advanced cancer. Clin Cancer Res 1997;3:1093–1100.

    PubMed  CAS  Google Scholar 

  23. van den Bent MJ, Chinot O, Boogerd W, et al. Second-line chemotherapy with temozolomide in recurrent oligodendroglioma after PCV (procarbazine, lomustine and vincristine) chemotherapy: EORTC Brain Tumor Group phase II study 26972. Ann Oncol 2003;14:599–602.

    Article  PubMed  Google Scholar 

  24. Rodriguez LA, Prados M, Silver P, Levin VA. Reevaluation of procarbazine for the treatment of recurrent malignant central nervous system tumors. Cancer 1989;64:2420–2423.

    Article  PubMed  CAS  Google Scholar 

  25. Hare CB, Elion GB, Houghton PJ, et al. Therapeutic efficacy of the topoisomerase I inhibitor 7-ethyl-10-(4-[1-piperidino]-1-piperidino)-carbonyloxy-camptothecin against pediatric and adult central nervous system tumor xenografts. Cancer Chemother Pharmacol 1997;39(3):187–191.

    Article  PubMed  CAS  Google Scholar 

  26. Friedman HS, Petros WP, Friedman AH, et al. Irinotecan therapy in adults with recurrent or progressive malignant glioma. J Clin Oncol 1999;17:1516–1525.

    PubMed  CAS  Google Scholar 

  27. Gruber ML, Buster WP. Temozolomide in combination with irinotecan for treatment of recurrent malignant glioma. Am J Clin Oncol 2004;27:33–38.

    Article  PubMed  CAS  Google Scholar 

  28. Meyskens FL Jr, Goodman GE, Alberts DS. 13-Cis-retinoic acid: pharmacology, toxicology, and clinical applications for the prevention and treatment of human cancer. Crit Rev Oncol Hematol 1985;3:75–101.

    Article  PubMed  Google Scholar 

  29. Wismeth C, Hau P, Fabel K, et al. Maintenance therapy with 13-cis retinoid acid in high-grade glioma at complete response after first-line multimodal therapy-aphase-II study. J Neurooncol 2004;68:79–86.

    Article  PubMed  Google Scholar 

  30. Couldwell WT, Antel JP, Yong VW. Protein kinase C activity correlates with the growth rate of malignant gliomas: PartII. Effects of glioma mitogens and modulators of protein kinase C. Neurosurgery 1992;31:717–724.

    Article  PubMed  CAS  Google Scholar 

  31. Couldwell WT, Hinton DR, Surnock AA, et al. Treatment of recurrent malignant gliomas with chronic oral high-dose tamoxifen. Clin Cancer Res 1996;2:619–622.

    PubMed  CAS  Google Scholar 

  32. Zhang W, Yamada H, Sakai N, Niikawa S, Nozawa Y. Enhancement of radiosensitivity by tamoxifen in C6 glioma cells. Neurosurgery 1992;31:725–729; discussion 729-730.

    Article  PubMed  CAS  Google Scholar 

  33. Brandes AA, Ermani M, Turazzi S, et al. Procarbazine and high-dose tamoxifen as a second-line regimen in recurrent high-grade gliomas: a phase II study. J Clin Oncol 1999;17:645–650.

    PubMed  CAS  Google Scholar 

  34. Chamberlain MC, Kormanik PA. Salvage chemotherapy with tamoxifen for recurrent anaplastic astrocytomas. Arch Neurol 1999;56:703–708.

    Article  PubMed  CAS  Google Scholar 

  35. Levin VA, Silver P, Hannigan J, et al. Superiority of post-radiotherapy adjuvant chemotherapy with CCNU, procarbazine, and vincristine (PCV) over BCNU for anaplastic gliomas: NCOG6G61 final report. Int J Radiat Oncol Biol Phys 1990;18:321–324.

    PubMed  CAS  Google Scholar 

  36. Longee DC, Friedman HS, Albright RE Jr, et al. Treatment of patients with recurrent gliomas with cyclophos-phamide and vincristine. J Neurosurg 1990;72:583–588.

    Article  PubMed  CAS  Google Scholar 

  37. Buckner JC, Brown LD, Cascino TL, et al. Phase II evaluation of infusional etoposide and cisplatin in patients with recurrent astrocytoma. J Neurooncol 1990;9:249–254.

    PubMed  CAS  Google Scholar 

  38. Watanabe K, Kanaya H, Fujiyama Y, Kim P. Combination chemotherapy using carboplatin (JM-8) and etoposide (JET therapy) for recurrent malignant gliomas: a phase II study. Acta Neurochir (Wien) 2002;144:1265–1270.

    Article  CAS  Google Scholar 

  39. Hellman RM, Calogero JA, Kaplan BM. VP-16, vincristine and procarbazine with radiation therapy for treatment of malignant brain tumors. J Neurooncol 1990;8:163–166.

    Article  PubMed  CAS  Google Scholar 

  40. Sanson M, Ameri A, Monjour A, et al. Treatment of recurrent malignant supratentorial gliomas with ifosfamide, carboplatin and etoposide: a phase II study. Eur J Cancer 1996;32A:2229–2235.

    Article  PubMed  CAS  Google Scholar 

  41. Newlands ES, Foster T, Zaknoen S. Phase I study of temozolamide (TMZ) combined with procarbazine (PCB) in patients with gliomas. Br J Cancer 2003;89:248–251.

    Article  PubMed  CAS  Google Scholar 

  42. Chang SM, Prados MD, Yung WK, et al. Phase II study of neoadjuvant 1,3-bis (2-chloroethyl)-1-nitrosourea and temozolomide for newly diagnosed anaplastic glioma: a North American Brain Tumor Consortium Trial. Cancer 2004;100:1712–1716.

    Article  PubMed  CAS  Google Scholar 

  43. Brandes AA, Basso U, Reni M, et al. Gruppo Italiano Cooperativo di Neuro-Oncologia. First-line chemotherapy with cisplatin plus fractionated temozolomide in recurrent glioblastoma multiforme: a phase II study of the Gruppo Italiano Cooperativo di Neuro-Oncologia. J Clin Oncol 2004;22:1598–1604.

    Article  PubMed  CAS  Google Scholar 

  44. Coyle T, Baptista J, Winfield J, et al. Mechlorethamine, vincristine, and procarbazine chemotherapy for recurrent high-grade glioma in adults: a phase II study. J Clin Oncol 1990;8:2014–2018.

    PubMed  CAS  Google Scholar 

  45. Stark-Vance V. Bevacizumab and CPT-11 in the treatment of relapsed malignant glioma. Neuro-Oncol 2005;7:369(abstr342).

    Google Scholar 

  46. Dresemann G. Imatinib and hydroxyurea in pretreated progressive glioblastoma multiforme: a patient series. Ann Oncol. 2005;16:1702–1708.

    Article  PubMed  CAS  Google Scholar 

  47. Chang CH, Horton J, Schoenfeld D, et al. Comparison of postoperative radiotherapy and combined postoperative radiotherapy and chemotherapy in the multidisciplinary management of malignant gliomas. A joint Radiation Therapy Oncology Group and Eastern Cooperative Oncology Group study. Cancer 1983;52:997–1007.

    Article  PubMed  CAS  Google Scholar 

  48. van Vulpen M, Kal HB, Taphoorn MJ, El-Sharouni SY. Changes in bloodbrain barrier permeability induced by radiotherapy: Implications for timing of chemotherapy? Oncol Rep 2002;9:683–688.

    PubMed  Google Scholar 

  49. Prados MD, Scott C, Curran WJ Jr, Nelson DF, Leibel S, Kramer S. Procarbazine, lomustine, and vincristine (PCV) chemotherapy for anaplastic astrocytoma: A retrospective review of radiation therapy oncology group protocols comparing survival with carmustine or PCV adjuvant chemotherapy. J Clin Oncol 1999;17:3389–3395.

    PubMed  CAS  Google Scholar 

  50. Medical Research Council Brain Tumor Working Party. Randomized trial of procarbazine, lomustine, and vincristine in the adjuvant treatment of high-grade astrocytoma: a Medical Research Council trial. J Clin Oncol 2001;19:509–518.

    Google Scholar 

  51. Grossman SA, O’eNeill A, Grunnet M, et al. Phase III study comparing three cycles of infusional carmustine and cisplatin followed by radiation therapy with radiation therapy and concurrent carmustine in patients with newly diagnosed supratentorial glioblastoma multiforme: Eastern Cooperative Oncology Group Trial 2394. J Clin Oncol 2003;21:1485–1491.

    Article  PubMed  CAS  Google Scholar 

  52. Fine HA, Dear KB, Loeffler JS, Black PM, Canellos GP. Meta-analysis of radiation therapy with and without adjuvant chemotherapy for malignant gliomas in adults. Cancer 1993;71:2585–2597.

    Article  PubMed  CAS  Google Scholar 

  53. Stewart LA. Chemotherapy in adult high-grade glioma: a systematic review and meta-analysis of individual patient data from 12 randomised trials. Lancet 2002;359:1011–1018.

    Article  PubMed  CAS  Google Scholar 

  54. Grossman SA, Fisher JD, Piantadosi S, Brem H. The New Approaches to Brain Tumor Therapy (NABTT) CNS Consortium: Organization, objectives and activities. Cancer Control 1998;5:107–114.

    PubMed  Google Scholar 

  55. Mathieu NT, Genet D, Labrousse F, et al. Pre-irradiation chemotherapy for newly diagnosed high grade astrocytoma. Anticancer Res 2004;24:1249–1253.

    PubMed  Google Scholar 

  56. Cairncross JG, Ueki K, Zlatescu M, et al. Specific genetic predictors of chemotherapeutic and survival in patients with anaplastic oligodendrogliomas. J Natl Cancer Inst 1998;90:1473–1479.

    Article  PubMed  CAS  Google Scholar 

  57. Ino Y, Betensky RA, Zlatescu MC, et al. Molecular subtypes of anaplastic oligodendroglioma: implications for patient management at diagnosis. Clin Cancer Res 2001;7:839–845.

    PubMed  CAS  Google Scholar 

  58. Perry JR, Louis DN, Cairncross JG. Current treatment of oligodendrogliomas. Arch Neurol 1999;56:434–436.

    Article  PubMed  CAS  Google Scholar 

  59. Fortin D, Cairncross GJ, Hammond RR. Oligodendroglioma: an appraisal of recent data pertaining to diagnosis and treatment. Neurosurgery 1999;45:1279–1291; discussion 1291.

    Article  PubMed  CAS  Google Scholar 

  60. Paleologos NA. Oligodendroglioma. Curr Treat Options Neurol 2001;3:59–66.

    Article  PubMed  Google Scholar 

  61. Peereboom DM, Kaur H, Wood L, et al. Phase II multicenter study of 7/7 dosing of temozolomide in patients with newly diagnosed pure and mixed anaplastic oligodendroglioma. Neuro-oncol 2005;7:401 (abstr 470).

    Google Scholar 

  62. Cairncross G, Macdonald D, Ludwin S, et al. Chemotherapy for anaplastic oligodendroglioma. National Cancer Institute of Canada Clinical Trials Group. J Clin Oncol 1994;12:2013–2021.

    PubMed  CAS  Google Scholar 

  63. van den bent MJ. Chemotherapy of Oligodendroglial tumors: current developments. Forum 2000;10:108–118.

    PubMed  Google Scholar 

  64. Bouffet E, Jouvet A, Thiesse P, Sindou M. Chemotherapy for aggressive or anaplastic high grade oligoden-drogliomas and oligoastrocytomas: better than a salvage treatment. Br J Neurosurg 1998;12:217–222.

    Article  PubMed  CAS  Google Scholar 

  65. Zander T, Nettekoven W, Kraus JA, et al. Intensified PCV-chemotherapy with optional stem cell support in recurrent malignant oligodendroglioma. J Neurol 2002;249:1055–1057.

    Article  PubMed  Google Scholar 

  66. van den Bent MJ, Taphoorn MJ, Brandes A A, et al. Phase II study of first-line chemotherapy with temozolomide in recurrent oligodendroglial tumors: the European Organization for Research and Treatment of Cancer Brain Tumor Group Study 26971. J Clin Oncol 2003;21:2525–2528.

    Article  PubMed  CAS  Google Scholar 

  67. Chahlavi A, Kanner A, Peereboom D, Staugaitis SM, Elson P, Barnett G. Impact of chromosome 1p status in response of oligodendroglioma to temozolomide: preliminary results. J Neurooncol 2003;61:267–73.

    Article  PubMed  Google Scholar 

  68. Chinot OL, Honore S, Dufour H, et al. Safety and efficacy of temozolomide in patients with recurrent anaplastic oligodendrogliomas after standard radiotherapy and chemotherapy. J Clin Oncol 2001;19:2449–2455.

    PubMed  CAS  Google Scholar 

  69. Chamberlain MC, Kormanik PA. Salvage chemotherapy with paclitaxel for recurrent oligodendrogliomas. J Clin Oncol 1997;15:3427–3432.

    PubMed  CAS  Google Scholar 

  70. Peereboom D, Kaur H, Wood L, et al. Phase II multicenter study of dose-intense (7days on/7days off) temozolomide in patients with newly diagnosed pure and mixed anaplastic oligodendroglioma. J Neuro-oncol 2003;5:353.

    Google Scholar 

  71. Yung WK, Prados MD, Yaya-Tur R, et al. Multicenter phase II trial of temozolomide in patients with anaplastic astrocytoma or anaplastic oligoastrocytoma at first relapse. Temodal Brain Tumor Group. J Clin Oncol 1999;17:2762–2771, erratum: J Clin Oncol 1999;17:3693.

    PubMed  CAS  Google Scholar 

  72. Kerbel RS, Kamen B A. The anti-angiogenic basis of metronomic chemotherapy. Nature Reviews. Cancer 2004;4:423–436.

    Article  PubMed  CAS  Google Scholar 

  73. Wong ET, Hess KR, Gleason MJ, et al. Outcomes and prognostic factors in recurrent glioma patients enrolled onto phase II clinical trials. J Clin Oncol. 1999;17:2572–2578.

    PubMed  CAS  Google Scholar 

  74. Hegi ME, Diserens AC, Gorlia T, et al. MGMT gene silencing and benefit from temozolomide in glioblastoma. N Engl J Med. 2005;352:997–1003.

    Article  PubMed  CAS  Google Scholar 

  75. Mellinghoff IK, Wang MY, Vivanco I, et al. Molecular determinants of the response of glioblastomas to EGFR kinase inhibitors. N Engl J Med 2005;353:2012–2024.

    Article  PubMed  CAS  Google Scholar 

  76. Brem H, Piantadosi S, Burger PC, et al. Placebo-controlled trial of safety and efficacy of intraoperative controlled delivery by biodegradable polymers of chemotherapy for recurrent gliomas. The Polymer-brain Tumor Treatment Group. Lancet 1995;345:1008–1012.

    Article  PubMed  CAS  Google Scholar 

  77. Westphal M, Hilt DC, Bortey E, et al. Ram Z. A phase 3 trial of local chemotherapy with biodegradable carmustine (BCNU) wafers (Gliadel wafers) in patients with primary malignant glioma. Neuro-oncology 2003;5:79–88.

    Article  PubMed  CAS  Google Scholar 

  78. Johnson DB, Thompson JM, Corwin JA, et al. Prolongation of survival for high-grade malignant gliomas with adjuvant high-dose BCNU and autologous bone marrow transplantation. J Clin Oncol 1987;5:783–789.

    PubMed  CAS  Google Scholar 

  79. Chen B, Ahmed T, Mannancheril A, Gruber M, Benzil DL. Safety and efficacy of high-dose chemotherapy with autologous stem cell transplantation for patients with malignant astrocytomas. Cancer 2004;100:2201–2207.

    Article  PubMed  CAS  Google Scholar 

  80. Abrey LE, Childs BH, Paleologos N, et al. High-dose chemotherapy with stem cell rescue as initial therapy for anaplastic oligodendroglioma. J Neuro-oncol 2003;5:127–134.

    Article  Google Scholar 

  81. Newton HB, Slivka MA, Stevens CL, et al. Intra-arterial carboplatin and intravenous etoposide for the treatment of recurrent and progressive non-GBM gliomas. J Neuro-oncol 2002;56:79–86.

    Article  Google Scholar 

  82. Chow KL, Gobin YP, Cloughesy T, et al. Prognostic factors in recurrent glioblastoma multiforme and anaplastic astrocytoma treated with selective intra-arterial chemotherapy. Am J Neurorad 2000;21:471–478.

    CAS  Google Scholar 

  83. Doolittle ND, Miner ME, Hall WA, et al. Safety and efficacy of a multicenter study using intraarterial chemotherapy in conjuction with osmotic opening of the blood-brain barrier for the treatment of malignant brain tumors. Cancer 2000;88:637–647.

    Article  PubMed  CAS  Google Scholar 

  84. Fortin D, Desjardins A, Benko A, et al. Enhanced chemotherapy delivery by intraarterial infusion and blood-brain barrier disruption in malignant brain tumors. Cancer 2005; 103:2606–2615.

    Article  PubMed  Google Scholar 

  85. Pegg AE, Dolan ME, Moschel RC. Structure, function, and inhibition of O6-alkylguanine-DNA alkyltransferase. Prog Nucleic Acid Res Mol Biol 1995;51:167–223.

    Article  PubMed  CAS  Google Scholar 

  86. Spiro TP, Gerson SL, Liu L, et al. O6-benzylguanine: a clinical trial establishing the biochemical modulatory dose in tumor tissue for alkyltransferase-directed DNA repair. Cancer Res 1999;59:2402–2510.

    PubMed  CAS  Google Scholar 

  87. Quinn JA, Desjardins A, Weingart J, et al. Phase I trial of temozolomide plus o6-benzylguanine for patients with recurrent or progressive malignant glioma. J Clin Oncol 2005;23:7178–7187.

    Article  PubMed  CAS  Google Scholar 

  88. Tolcher AW, Gerson SL, Denis L, et al. Marked inactivation of O6-alkylguanine-DNA alkyltransferase activity with protracted temozolomide schedules. Br J Cancer 2003;88:1004–1011.

    Article  PubMed  CAS  Google Scholar 

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Ahluwalia, M.S., Peereboom, D.M. (2007). Chemotherapy. In: Barnett, G.H. (eds) High-Grade Gliomas. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-59745-185-7_16

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