title: Should concomitant and adjuvant treatment with temozolomide be used as standard therapy in patients with anaplastic glioma?
abstract: Malignant gliomas are devastating tumors associated with poor prognosis. Standard treatment has been surgery followed by radiotherapy while the role of chemotherapy has remained controversial. Concomitant and adjuvant treatment with temozolomide has recently been shown to improve survival in patients with glioblastoma. While it seems intuitive to apply this regimen to patients with anaplastic gliomas which have traditionally been considered more chemosensitive, chemotherapy has not been shown to prolong life in patients with anaplastic gliomas. Despite promising preclinical and early clinical results, there is currently not enough level 1 evidence to justify concomitant and adjuvant temozolomide as standard therapy for patients with newly diagnosed anaplastic gliomas. Further investigation is needed to better define the role of chemotherapy in patients with anaplastic gliomas. Trials evaluating chemoradiotherapy as well as targeted therapeutic agents are the subject of further research.
authors.affiliation: Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, K4.3, Madison, WI 53792-8500, USA.
authors.forename: Malika L
authors.initials: ML
authors.lastname: Siker
authors.forename: Arnab
authors.initials: A
authors.lastname: Chakravarti
authors.forename: Minesh P
authors.initials: MP
authors.lastname: Mehta
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001254:Astrocytoma / Q000188:drug therapy* / Q000235:genetics / Q000532:radiotherapy; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000532:radiotherapy; D002277:Carcinoma / Q000188:drug therapy / Q000235:genetics / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D015254:DNA Modification Methylases; D045643:DNA Repair Enzymes; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D009837:Oligodendroglioma / Q000188:drug therapy / Q000235:genetics / Q000532:radiotherapy; D016879:Salvage Therapy; D000077204:Temozolomide; D025803:Tumor Suppressor Protein p14ARF / Q000235:genetics; D025521:Tumor Suppressor Proteins
chemical_list: D018906:Antineoplastic Agents, Alkylating; D025803:Tumor Suppressor Protein p14ARF; D025521:Tumor Suppressor Proteins; D003606:Dacarbazine; D015254:DNA Modification Methylases; C515491:MGMT protein, human; D045643:DNA Repair Enzymes; D000077204:Temozolomide