title: Complete response after one cycle of temozolomide in an elderly patient with glioblastoma and poor performance status.
abstract: There is no standard of care for elderly patients with glioblastoma (GBM) and poor performance status. A 79-year-old woman with GBM, aphasia, and hemiplegia achieved a complete response after only one cycle of temozolomide (TMZ) (150mg/m2/day over 5 days). Genomic profiling of the tumor demonstrated loss of chromosome 10 and MDM2 amplification, which are predictive of poor outcome. The MGMT promoter was methylated, and it is likely that this at least partially explains the exquisite chemosensitivity in our patient. This unusual case report suggests that TMZ warrants further investigation in elderly patients with poor performance status.
authors.affiliation: INSERM, Unité U711, Université Pierre et Marie Curie Paris VI, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Ducray
authors.forename: Alexandra
authors.initials: A
authors.lastname: Benouaich-Amiel
authors.forename: Ahmed
authors.initials: A
authors.lastname: Idbaih
authors.forename: Audrey
authors.initials: A
authors.lastname: Rousseau
authors.forename: Florence
authors.initials: F
authors.lastname: Laigle-Donadey
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Delattre
authors.forename: Marc
authors.initials: M
authors.lastname: Sanson
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D002872:Chromosome Deletion; D041321:Chromosomes, Human, X / Q000235:genetics; D019175:DNA Methylation; D015254:DNA Modification Methylases / Q000235:genetics; D045643:DNA Repair Enzymes / Q000235:genetics; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005909:Glioblastoma / Q000150:complications / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D006801:Humans; D000077204:Temozolomide; D014057:Tomography, X-Ray Computed; D025521:Tumor Suppressor Proteins / Q000235:genetics
chemical_list: D018906:Antineoplastic Agents, Alkylating; D025521:Tumor Suppressor Proteins; D003606:Dacarbazine; D015254:DNA Modification Methylases; C515491:MGMT protein, human; D045643:DNA Repair Enzymes; D000077204:Temozolomide