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Journal of Neuro-Oncology

, Volume 124, Issue 3, pp 413–420 | Cite as

Phase II trial of pre-irradiation and concurrent temozolomide in patients with newly diagnosed anaplastic oligodendrogliomas and mixed anaplastic oligoastrocytomas: long term results of RTOG BR0131

  • Michael A. Vogelbaum
  • Chen Hu
  • David M. Peereboom
  • David R. Macdonald
  • Caterina Giannini
  • John H. Suh
  • Robert B. Jenkins
  • Nadia N. Laack
  • David G. Brachman
  • Dennis C. Shrieve
  • Luis Souhami
  • Minesh P. Mehta
Clinical Study

Abstract

We report on the long-term results of a phase II study of pre-irradiation temozolomide followed by concurrent temozolomide and radiotherapy (RT) in patients with newly diagnosed anaplastic oligodendroglioma (AO) and mixed anaplastic oligoastrocytoma. Pre-RT temozolomide was given for up to 6 cycles. RT with concurrent temozolomide was administered to patients with less than a complete radiographic response. Forty eligible patients were entered and 32 completed protocol treatment. With a median follow-up time of 8.7 years (range 1.1–10.1), median progression-free survival (PFS) is 5.8 years (95 % CI 2.0, NR) and median overall survival (OS) has not been reached (5.9, NR). 1p/19q data are available in 37 cases; 23 tumors had codeletion while 14 tumors had no loss or loss of only 1p or 19q (non-codeleted). In codeleted patients, 9 patients have progressed and 4 have died; neither median PFS nor OS have been reached and two patients who received only pre-RT temozolomide and no RT have remained progression-free for over 7 years. 3-year PFS and 6-year OS are 78 % (95 % CI 61–95 %) and 83 % (95 % CI 67–98 %), respectively. Codeleted patients show a trend towards improved 6-year survival when compared to the codeleted procarbazine/CCNU/vincristrine (PCV) and RT cohort in RTOG 9402 (67 %, 95 % CI 55–79 %). For non-codeleted patients, median PFS and OS are 1.3 and 5.8 years, respectively. These updated results suggest that the regimen of dose intense, pre-RT temozolomide followed by concurrent RT/temozolomide has significant activity, particularly in patients with 1p/19q codeleted AOs and MAOs.

Keywords

Oligodendroglioma Temozolomide 1p/19q loss of heterozygosity MGMT RTOG 

Notes

Acknowledgments

This project was supported by Grants U10CA21661, U10CA180868, U10CA180822, U10 CA37422, U24CA180803 from the National Cancer Institute (NCI). Portions of this work have been presented in abstract form (Society for NeuroOncology, 2012).

Conflict of interest

The following authors have disclosed financial relationships with commercial entities that may be impacted by this work. DMP—Merck (research support, honoraria). DRM—Merck Canada (honoraria, travel support), Roche Canada (honoraria, travel support). JHS—Varian Medical System (consultant). The following authors declare no conflicts of interests with respect this work: MAV, CH, CG, RBJ, NNL, DCS, LS, DB, MPM

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Michael A. Vogelbaum
    • 1
  • Chen Hu
    • 2
  • David M. Peereboom
    • 1
  • David R. Macdonald
    • 3
  • Caterina Giannini
    • 4
  • John H. Suh
    • 1
  • Robert B. Jenkins
    • 4
  • Nadia N. Laack
    • 4
  • David G. Brachman
    • 5
  • Dennis C. Shrieve
    • 6
  • Luis Souhami
    • 7
  • Minesh P. Mehta
    • 8
  1. 1.Cleveland Clinic FoundationClevelandUSA
  2. 2.RTOG Statistical CenterPhiladelphiaUSA
  3. 3.University of Western Ontario London Regional Cancer CentreLondonCanada
  4. 4.Mayo ClinicRochesterUSA
  5. 5.Arizona Oncology Services FoundationPhoenixUSA
  6. 6.University of Utah Health Science CenterSalt Lake CityUSA
  7. 7.McGill UniversityMontrealCanada
  8. 8.University of MarylandBaltimoreUSA

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