title: Temozolomide dosing regimens for glioma patients.
abstract: Even in modern times of high-precision brain surgery and irradiation, malignant gliomas belong to the deadliest types of cancer. Due to a marked primary and presumably also acquired resistance, the beneficial effects of cytotoxic chemotherapy are limited. Only one randomized clinical trial demonstrated a significant impact on overall survival with temozolomide. Ever since, there have been attempts to improve the efficacy of alkylating chemotherapy by modulating the distribution of dose in time aiming at a better treatment success. Apart from higher cumulative doses per cycle, better efficacy by depletion of the anti-alkylating O⁶-methylguanine-DNA methyltransferase (MGMT) protein has been a major goal of these regimens. After promising results of single-arm pilot studies, however, randomized studies have been disappointing so far. In this overview, the different strategies of dose-dense temozolomide regimen are highlighted and results of clinical trials put into perspective.
authors.affiliation: Department of Neurology, Medical School, University of Marburg, Baldinger Strasse, 35043 Marburg, Germany. strik@med.uni-marburg.de
authors.forename: Herwig M
authors.initials: HM
authors.lastname: Strik
authors.forename: Christine
authors.initials: C
authors.lastname: Marosi
authors.forename: Bernd
authors.initials: B
authors.lastname: Kaina
authors.forename: Bart
authors.initials: B
authors.lastname: Neyns
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy*; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005910:Glioma / Q000188:drug therapy*; D006801:Humans; D000077204:Temozolomide; D013997:Time Factors
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D000077204:Temozolomide