title: Temozolomide is active in childhood, progressive, unresectable, low-grade gliomas.
abstract: OBJECTIVE
  To assess the activity and tolerability of temozolomide in children with progressive low-grade gliomas (LGGs).
  
  
  METHODS
  The authors reviewed the records of 13 children (6 months to 19 years old) with progressive LGGs and magnetic resonance imaging evidence of unresectable tumors who were treated with temozolomide at the authors' institution since 1999.
  
  
  RESULTS
  Four patients received a 5-day regimen of temozolomide (150 mg/m2 per day) repeated every 28 days, and nine patients received a 42-day regimen (75 mg/m2 per day) repeated every 56 days. Three patients demonstrated partial responses to temozolomide, with a median time to maximal response of 5 months (range 4-12 months), and one had a minor response at 9 months. Four patients developed progression while on temozolomide, with a median time to progression of 7 months (range 1-12 months). Five patients had disease stabilization. Among the five patients with prior chemotherapy and/or radiation therapy, temozolomide was associated with disease stabilization in three and tumor response in one. In the three patients with neurofibromatosis type 1, two patients experienced tumor responses and one disease stabilization. Thrombocytopenia, nausea, emesis, and fatigue were the most common toxicities. Four patients discontinued therapy because of the side effects.
  
  
  CONCLUSIONS
  Temozolomide is active in children with LGGs. It is effective in previously treated patients and in patients with neurofibromatosis type 1. The 42-day regimen appears less toxic than the 5-day regimen. Any impact on survival for these patients remains to be demonstrated.
authors.affiliation: Department of Pediatrics, New York University, New York, USA.
authors.forename: Dennis J
authors.initials: DJ
authors.lastname: Kuo
authors.forename: Howard L
authors.initials: HL
authors.lastname: Weiner
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wisoff
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Miller
authors.forename: Edmond A
authors.initials: EA
authors.lastname: Knopp
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Finlay
mesh_terms: D000293:Adolescent; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D005910:Glioma / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D000077204:Temozolomide
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide