Optimal role of temozolomide in the treatment of malignant gliomas.
Temozolomide (TMZ) is an alkylating agent that was approved for anaplastic astrocytoma and glioblastoma. Its role in the treatment of recurrent disease has been confirmed, and more importantly, alternative treatment schedules and combination regimens have been developed. A recent phase III trial has demonstrated a survival advantage for concomitant TMZ administration with radiotherapy in patients with newly diagnosed glioblastoma. Molecular studies suggest a strong predictive role of the DNA repair enzyme O6-methyl-guanine-DNA-methyl-transferase (MGMT) and outcome of TMZ-based chemotherapy. This review summarizes the current knowledge, highlights approved and nonapproved indications, and describes molecular studies that may allow us to identify the patients most likely to benefit from this treatment.
Stupp
Roger
R
Multidisciplinary Oncology Center, University of Lausanne Hospitals, 46 rue du Bugnon, Lausanne 1011, Switzerland. Roger.Stupp@chuv.hospvd.ch
van den Bent
Martin J
MJ
Hegi
Monika E
ME
D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage* / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005910:Glioma / Q000145:classification / Q000188:drug therapy*; D006801:Humans; D000077204:Temozolomide
D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide