title: Temozolomide single-agent chemotherapy for newly diagnosed anaplastic oligodendroglioma.
abstract: The treatment of patients with anaplastic oligodendroglioma (AO) has been significantly impacted by the molecular detection of loss of sequences on chromosomes 1p and 19q. We performed a clinical trial to prospectively evaluate the safety of treating patients with AO with temozolomide (TMZ) alone in patients with chromosome 1p/19q loss and with chemo-radiation in patients not harboring this loss. Forty-eight patients were enrolled, 36/48 (75%) with evidence of chromosome 1p/19q loss treated with TMZ alone and 12/18 (25%) without such losses, treated with pre-radiation TMZ followed by chemo-radiation. Despite more aggressive treatment, patients without 1p/19q loss had a shorter progression-free survival (PFS) of 13.5 months. With a median follow-up time of 32 months, patients with 1p/19q LOH had a median TTP of 28.7 months. Patients with AO with 1p/19q LOH can be safely treated with single-agent TMZ and do not appear to experience earlier or more frequent tumor progression. This treatment regimen should be studied as part of a formal randomized clinical trial.
authors.affiliation: Hermelin Brain Tumor Center, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI 48202, USA. nstom@neuro.hfh.edu
authors.forename: T
authors.initials: T
authors.lastname: Mikkelsen
authors.forename: T
authors.initials: T
authors.lastname: Doyle
authors.forename: J
authors.initials: J
authors.lastname: Anderson
authors.forename: J
authors.initials: J
authors.lastname: Margolis
authors.forename: N
authors.initials: N
authors.lastname: Paleologos
authors.forename: J
authors.initials: J
authors.lastname: Gutierrez
authors.forename: D
authors.initials: D
authors.lastname: Croteau
authors.forename: L
authors.initials: L
authors.lastname: Hasselbach
authors.forename: R
authors.initials: R
authors.lastname: Avedissian
authors.forename: L
authors.initials: L
authors.lastname: Schultz
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000532:radiotherapy; D002878:Chromosomes, Human, Pair 1 / Q000235:genetics; D002888:Chromosomes, Human, Pair 19 / Q000235:genetics; D003131:Combined Modality Therapy; D019175:DNA Methylation; D015254:DNA Modification Methylases / Q000235:genetics; D045643:DNA Repair Enzymes / Q000235:genetics; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D019656:Loss of Heterozygosity; D009837:Oligodendroglioma / Q000188:drug therapy* / Q000235:genetics / Q000532:radiotherapy; D011379:Prognosis; D011401:Promoter Regions, Genetic / Q000235:genetics; D000077204:Temozolomide; 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