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Journal of Clinical Oncology, Vol 22, No 15 (August 1), 2004: pp. 3133-3138
© 2004 American Society of Clinical Oncology.
DOI: 10.1200/JCO.2004.10.169
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Temozolomide As Initial Treatment for Adults With Low-Grade Oligodendrogliomas or Oligoastrocytomas and Correlation With Chromosome 1p Deletions

K. Hoang-Xuan, L. Capelle, M. Kujas, S. Taillibert, H. Duffau, J. Lejeune, M. Polivka, E. Crinière, Y. Marie, K. Mokhtari, A.F. Carpentier, F. Laigle, J.M. Simon, P. Cornu, P. Broët, M. Sanson, J.Y. Delattre

From the Fédération Neurologique Mazarin, Service de Neurochirurgie, Laboratoire de Neuropathologie, and Service de Radiothérapie, Groupe Hospitalier Pitié-Salpêtrière; Institut National de la Santé et de la Recherche Médicale U495; Université P. et M. Curie; Service d'Anatomopathologie, Hôpital Lariboisière, Paris; and Unité de Biostatistique, INSERM U472, Villejuif, France

Address reprint requests to K. Hoang-Xuan, MD, Fédération Neurologique Mazarin and INSERM U495, Groupe Hospitalier Pitié-Salpêtrière, 47 Blvd de l'Hôpital, 75651 Paris Cedex 13, France; e-mail: khe.hoang-xuan{at}psl.ap-hop-paris.fr

PURPOSE: To determine the response rate of low-grade oligodendroglial tumors (LGOT) to temozolomide (TMZ) as initial treatment and to evaluate the predictive value of chromosome 1p deletion on the radiologic response.

PATIENTS AND METHODS: Adult patients with pathologically proven LGOT with progressive disease on magnetic resonance imaging (MRI) were eligible for the study. TMZ was administered at the starting dose of 200 mg/m2/d for 5 days, repeated every 28 days. Response was evaluated clinically and by central review of MRIs. Chromosome 1p and 19q deletions were detected by the loss of heterozygosity technique.

RESULTS: Sixty consecutive patients were included in the study. At the time of analysis, the median number of TMZ cycles delivered was 11. Clinically, 51% of patients improved, particularly those with uncontrolled epilepsy. The objective radiologic response rate was 31% (17% partial response and 14% minor response), whereas 61% of patients had stable disease and 8% experienced disease progression. The median time to maximum tumor response was 12 months (range, 5 to 20 months). Myelosuppression was the most frequent side effect, with grade 3 to 4 toxicity in 8% of patients. Loss of chromosome 1p was associated with objective tumor response (P < .004).

CONCLUSION: TMZ is well tolerated and provides a substantial rate of response in LGOT. Chromosome 1p loss is correlated with radiographic response and could be a helpful marker for guiding therapeutic decision making in LGOT.

Supported by a grant from the Fondation de France (grant No. 2002008957).

Authors' disclosures of potential conflicts of interest are found at the end of this article.




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