Journal of Clinical Oncology, Vol 21, Issue 13
(July), 2003: 2525-2528
© 2003 American Society for Clinical Oncology
Phase II Study of First-Line Chemotherapy With Temozolomide in Recurrent Oligodendroglial Tumors: The European Organization for Research and Treatment of Cancer Brain Tumor Group Study 26971
M.J. van den Bent,
M.J.B. Taphoorn,
A.A. Brandes,
J. Menten,
R. Stupp,
M. Frenay,
O. Chinot,
J.M. Kros,
C.C.D. van der Rijt,
Ch.J. Vecht,
A. Allgeier,
T. Gorlia
From the Departments of Neuro-Oncology, Pathology, and Medical Oncology, University Hospital Rotterdam/Rotterdam Cancer Center, Rotterdam; Department of Neurology, University Medical Center Utrecht, Utrecht; and Department of Neurology, Medical Center Haaglanden/Westeinde, the Hague, the Netherlands; Medical Oncology Department, University Hospital, Padova, Italy; Department of Radiotherapy-Oncology, Univeersitair Ziekenhuis Gasthuisberg, Leuven; European Organization for Research and Treatment of Cancer DataCenter, Brussels, Belgium; Department of Medical Oncology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; Centre Antoine Lacassagne, Nice; and Hôpital la Timone, Marseille, France.
Address reprint requests to M.J. van den Bent, Department of Neuro-Oncology, University Hospital Rotterdam/Rotterdam Cancer Center, PO Box 5201, 3008 AE Rotterdam, the Netherlands; email: m.vandenbent{at}erasmusmc.nl.
Purpose: Oligodendroglial tumors are chemotherapy-sensitive tumors, with two thirds of patients responding to combination chemotherapy with procarbazine, lomustine, and vincristine (PCV). Temozolomide (TMZ), a new alkylating and methylating agent, has demonstrated high response rates in patients with recurrent anaplastic astrocytoma. We investigated TMZ as first-line chemotherapy in recurrent oligodendroglial tumors (OD) and mixed oligoastrocytomas (OA) after surgery and radiation therapy.
Patients and Methods: In a prospective, nonrandomized, multicenter, phase II trial, patients were treated with 200 mg/m2 of TMZ on days 1 through 5 in 28-day cycles for 12 cycles. Patients with a recurrence after prior surgery and radiotherapy, and with measurable and enhancing disease on magnetic resonance imaging (MRI) were eligible for this study. Patients with large lesions and mass effect or with new clinical deficits were not eligible. Pathology and the MRI scans of all responding patients were centrally reviewed.
Results: Thirty-eight eligible patients were included. In three patients, pathology review did not confirm the presence of an OD or OA. TMZ was generally well tolerated. The most frequent side effects were hematologic; only one patient discontinued treatment for toxicity. In 20 (52.6%) of 38 patients (95% exact confidence interval, 35.8% to 69.0%), a complete (n = 10) or partial response to TMZ was observed. The median time to progression was 10.4 months for all patients and 13.2 months for responding patients. At 12 months from the start of treatment, 40% of patients were still free from progression.
Conclusion: TMZ provides an excellent response rate with good tolerability in chemotherapy-naive patients with recurrent OD. A randomized phase III study comparing PCV with TMZ is warranted.
Supported in part by a grant from Schering-Plough, Kenilworth, NJ. Presented orally at the Thirty-Eighth Annual Meeting of the American Society of Clinical Oncology, Orlando, FL, May 18-21, 2002, and at the Fifth Congress of the European Association for Neuro-Oncology, Florence, Italy, September 7–10, 2002.
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Facebook  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
S. Taillibert, L. A. Vincent, B. Granger, Y. Marie, C. Carpentier, R. Guillevin, A. Bellanger, K. Mokhtari, A. Rousseau, D. Psimaras, et al.
Bevacizumab and irinotecan for recurrent oligodendroglial tumors
Neurology,
May 5, 2009;
72(18):
1601 - 1606.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Stupp, F. Roila, and On behalf of the ESMO Guidelines Working Group
Malignant glioma: ESMO Clinical Recommendations for diagnosis, treatment and follow-up
Ann. Onc.,
May 1, 2009;
20(suppl_4):
iv126 - iv128.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Vogelbaum, B. Berkey, D. Peereboom, D. Macdonald, C. Giannini, J. H. Suh, R. Jenkins, J. Herman, P. Brown, D. T. Blumenthal, et al.
Phase II trial of preirradiation and concurrent temozolomide in patients with newly diagnosed anaplastic oligodendrogliomas and mixed anaplastic oligoastrocytomas: RTOG BR0131
Neuro-oncol,
January 1, 2009;
11(2):
167 - 175.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. S. Nielsen, H. C. Christensen, M. Kosteljanetz, and C. Johansen
Incidence of and survival from oligodendroglioma in Denmark, 1943-2002
Neuro-oncol,
January 1, 2009;
11(3):
311 - 317.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Kesari, D. Schiff, J. Drappatz, D. LaFrankie, L. Doherty, E. A. Macklin, A. Muzikansky, S. Santagata, K. L. Ligon, A. D. Norden, et al.
Phase II Study of Protracted Daily Temozolomide for Low-Grade Gliomas in Adults
Clin. Cancer Res.,
January 1, 2009;
15(1):
330 - 337.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. P. Mason and J. G. Cairncross
Invited Article: The expanding impact of molecular biology on the diagnosis and treatment of gliomas
Neurology,
July 29, 2008;
71(5):
365 - 373.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Nagane, K. Kobayashi, A. Ohnishi, S. Shimizu, and Y. Shiokawa
Prognostic Significance of O6-Methylguanine-DNA Methyltransferase Protein Expression in Patients with Recurrent Glioblastoma Treated with Temozolomide
Jpn. J. Clin. Oncol.,
December 21, 2007;
(2007)
hym132v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. C. Buckner, P. D. Brown, B. P. O'Neill, F. B. Meyer, C. J. Wetmore, and J. H. Uhm
Central Nervous System Tumors
Mayo Clin. Proc.,
October 1, 2007;
82(10):
1271 - 1286.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Schiff, P. D. Brown, and C. Giannini
Outcome in adult low-grade glioma: The impact of prognostic factors and treatment
Neurology,
September 25, 2007;
69(13):
1366 - 1373.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. E. Abrey, D. N. Louis, N. Paleologos, A. B. Lassman, J. J. Raizer, W. Mason, J. Finlay, D. R. MacDonald, L. M. DeAngelis, J. G. Cairncross, et al.
Survey of treatment recommendations for anaplastic oligodendroglioma
Neuro-oncol,
July 1, 2007;
9(3):
314 - 318.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. A. Brandes, A. Tosoni, G. Cavallo, M. Reni, E. Franceschi, L. Bonaldi, R. Bertorelle, M. Gardiman, C. Ghimenton, P. Iuzzolino, et al.
Correlations Between O6-Methylguanine DNA Methyltransferase Promoter Methylation Status, 1p and 19q Deletions, and Response to Temozolomide in Anaplastic and Recurrent Oligodendroglioma: A Prospective GICNO Study
J. Clin. Oncol.,
October 10, 2006;
24(29):
4746 - 4753.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. R. Gilbert and F. F. Lang
Anaplastic Oligodendroglial Tumors: A Tale of Two Trials
J. Clin. Oncol.,
June 20, 2006;
24(18):
2689 - 2690.
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Cairncross, B. Berkey, E. Shaw, R. Jenkins, B. Scheithauer, D. Brachman, J. Buckner, K. Fink, L. Souhami, N. Laperierre, et al.
Phase III Trial of Chemotherapy Plus Radiotherapy Compared With Radiotherapy Alone for Pure and Mixed Anaplastic Oligodendroglioma: Intergroup Radiation Therapy Oncology Group Trial 9402
J. Clin. Oncol.,
June 20, 2006;
24(18):
2707 - 2714.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. A. Jaeckle, K. V. Ballman, R. D. Rao, R. B. Jenkins, and J. C. Buckner
Current Strategies in Treatment of Oligodendroglioma: Evolution of Molecular Signatures of Response
J. Clin. Oncol.,
March 10, 2006;
24(8):
1246 - 1252.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Ranson, M. R. Middleton, J. Bridgewater, S. M. Lee, M. Dawson, D. Jowle, G. Halbert, S. Waller, H. McGrath, L. Gumbrell, et al.
Lomeguatrib, a Potent Inhibitor of O6-Alkylguanine-DNA-Alkyltransferase: Phase I Safety, Pharmacodynamic, and Pharmacokinetic Trial and Evaluation in Combination with Temozolomide in Patients with Advanced Solid Tumors
Clin. Cancer Res.,
March 1, 2006;
12(5):
1577 - 1584.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Stupp, M. E. Hegi, M. J. van den Bent, W. P. Mason, M. Weller, R. O. Mirimanoff, J. G. Cairncross, and on behalf of the European Organisation for Researc
Changing paradigms--an update on the multidisciplinary management of malignant glioma.
Oncologist,
February 1, 2006;
11(2):
165 - 180.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. J. French, S. M.A. Swagemakers, J. H.A. Nagel, M. C.M. Kouwenhoven, E. Brouwer, P. van der Spek, T. M. Luider, J. M. Kros, M. J. van den Bent, and P. A. Sillevis Smitt
Gene Expression Profiles Associated with Treatment Response in Oligodendrogliomas
Cancer Res.,
December 15, 2005;
65(24):
11335 - 11344.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. D. Voloschin, D. N. Louis, G. R. Cosgrove, and T. T. Batchelor
Neoadjuvant temozolomide followed by complete resection of a 1p- and 19q-deleted anaplastic oligoastrocytoma: Case study
Neuro-oncol,
January 1, 2005;
7(1):
97 - 100.
[Abstract]
[PDF]
|
|
|
|
|
|
|
E. Greanya, S. Taylor, F H. BscPharm, J Barnett, and B Thiessen
Temozolomide for malignant gliomas in British Columbia: A population-based cost-effectiveness analysis
Journal of Oncology Pharmacy Practice,
December 1, 2004;
10(4):
201 - 209.
[Abstract]
[PDF]
|
|
|
|
|
|
|
V. H.J.M. Triebels, M. J.B. Taphoorn, A. A. Brandes, J. Menten, M. Frenay, A. Tosoni, J. M. Kros, E. B.-t. Stege, R. H. Enting, A. Allgeier, et al.
Salvage PCV chemotherapy for temozolomide-resistant oligodendrogliomas
Neurology,
September 14, 2004;
63(5):
904 - 906.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. Hoang-Xuan, L. Capelle, M. Kujas, S. Taillibert, H. Duffau, J. Lejeune, M. Polivka, E. Criniere, Y. Marie, K. Mokhtari, et al.
Temozolomide As Initial Treatment for Adults With Low-Grade Oligodendrogliomas or Oligoastrocytomas and Correlation With Chromosome 1p Deletions
J. Clin. Oncol.,
August 1, 2004;
22(15):
3133 - 3138.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. F. Paz, R. Yaya-Tur, I. Rojas-Marcos, G. Reynes, M. Pollan, L. Aguirre-Cruz, J. L. Garcia-Lopez, J. Piquer, M.-J. Safont, C. Balana, et al.
CpG Island Hypermethylation of the DNA Repair Enzyme Methyltransferase Predicts Response to Temozolomide in Primary Gliomas
Clin. Cancer Res.,
August 1, 2004;
10(15):
4933 - 4938.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Pace, A. Vidiri, E. Galie, M. Carosi, S. Telera, A. M. Cianciulli, P. Canalini, D. Giannarelli, B. Jandolo, and C. M. Carapella
Temozolomide chemotherapy for progressive low-grade glioma: clinical benefits and radiological response
Ann. Onc.,
December 1, 2003;
14(12):
1722 - 1726.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
