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Current Neurology and Neuroscience Reports

, Volume 12, Issue 3, pp 286–293 | Cite as

Temozolomide Dosing Regimens for Glioma Patients

  • Herwig M. StrikEmail author
  • Christine Marosi
  • Bernd Kaina
  • Bart Neyns
Neuro-Oncology (LE Abrey, Section Editor)

Abstract

Even in modern times of high-precision brain surgery and irradiation, malignant gliomas belong to the deadliest types of cancer. Due to a marked primary and presumably also acquired resistance, the beneficial effects of cytotoxic chemotherapy are limited. Only one randomized clinical trial demonstrated a significant impact on overall survival with temozolomide. Ever since, there have been attempts to improve the efficacy of alkylating chemotherapy by modulating the distribution of dose in time aiming at a better treatment success. Apart from higher cumulative doses per cycle, better efficacy by depletion of the anti-alkylating O6-methylguanine-DNA methyltransferase (MGMT) protein has been a major goal of these regimens. After promising results of single-arm pilot studies, however, randomized studies have been disappointing so far. In this overview, the different strategies of dose-dense temozolomide regimen are highlighted and results of clinical trials put into perspective.

Keywords

Chemotherapy Glioblastoma Temozolomide Nitrosourea MGMT 

Notes

Disclosure

Conflicts of interest: H.M. Strik: has been a consultant for Micromet; has received grant support from Medac GmbH, Novartis, Mundipharma; has received payment for lectures including service on speakers bureaus from Mundipharma and Essex/Merck; has received payment for development of educational presentations from Mundipharma; has received travel/accommodations/meeting expenses unrelated to activities listed from Medac, Mundipharma, and Essex/Merck; C. Marosi: none; B. Kaina: none; B. Neyns: none.

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Herwig M. Strik
    • 1
    Email author
  • Christine Marosi
    • 2
  • Bernd Kaina
    • 3
  • Bart Neyns
    • 4
  1. 1.Department of Neurology, Medical SchoolUniversity of MarburgMarburgGermany
  2. 2.Department of Medical OncologyUniversity of ViennaViennaAustria
  3. 3.Institute of ToxicologyUniversity Medical CenterMainzGermany
  4. 4.Medische OncologieBrusselBelgium

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