Journal of Neuro-Oncology

, Volume 104, Issue 2, pp 617–618 | Cite as

Combined chemotherapy with temozolomide and fotemustine in recurrent glioblastoma patients

  • Paola GavianiEmail author
  • A. Salmaggi
  • A. Silvani
Letter to the Editor


Both temozolomide (TMZ) and fotemustine (FTM) are considered to be active agents in recurrent glioblastoma. The objective of this study is to assess the efficacy and toxicity profile of a sequential combination of TMZ and FTM in recurrent glioblastoma after standard treatment with TMZ and radiotherapy. The rationale for evaluating this regimen was, in part, the single-agent activity of both agents against recurrent glioblastoma. Furthermore, temozolomide seems to reduce O6-alkylguanine DNA alkyltransferase (AGAT) activity in vitro, suggesting that temozolomide might enhance the antitumor activity of fotemustine by reducing AGAT activity [1].

Methods and statistical analysis

We planned to treat consecutive patients with recurrent glioblastoma (histologically proven at first diagnosis) after chemoradiation treatment with temozolomide and successive adjuvant temozolomide. The study was designed according to Simon minimax two-stage design (settings: P0 = 0.10, P1 = 0.25, a = 0...


Temozolomide Glioblastoma Multiforme BCNU Carmustine Procarbazine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Gander M, Leyvraz S, Decosterd L, Bonfanti M, Marzolini C, Shen F et al (1999) Sequential administration of temozolomide and fotemustine: depletion of O6-alkyl guanine-DNA transferase in blood lymphocytes and in tumours. Ann Oncol 10:831–838PubMedCrossRefGoogle Scholar
  2. 2.
    Wick A, Felsberg J, Steinbach JP, Herrlinger U, Platten M, Blaschke B, Meyermann R, Reifenberger G, Weller M, Wick W (2007) Efficacy and tolerability of temozolomide in an alternating weekly regimen in patients with recurrent glioma. J Clin Oncol 25(22):3357–3361PubMedCrossRefGoogle Scholar
  3. 3.
    Plowman J, Waud WR, Koutsoukos AD, Rubinstein LV, Moore TD, Grever MR (1994) Preclinical antitumor activity of temozolomide in mice: efficacy against human brain tumor xenografts and synergism with 1, 3-bis(2-chloroethyl)-1-nitrosourea. Cancer Res 54:3793–3799PubMedGoogle Scholar
  4. 4.
    Chang SM, Prados MD, Yung WKA et al (2004) 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 100:1712–1716PubMedCrossRefGoogle Scholar
  5. 5.
    Silvani A, Lamperti E, Gaviani P, Eoli M, Fiumani A, Salmaggi A, Falcone C, Filippini G, Botturi A, Boiardi A (2008) Salvage chemotherapy with procarbazine and fotemustine combination in the treatment of temozolomide treated recurrent glioblastoma patients. J Neurooncol 87(2):143–151PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  1. 1.Neuro-Oncology UnitFondazione IRCCS Istituto Neurologico C. BestaMilanItaly

Personalised recommendations