Temozolomide Versus Procarbazine, Lomustine, and Vincristine in Recurrent High-Grade Glioma

Brada, Michael; Stenning, Sally; Gabe, Rhian; Thompson, Lindsay C; Levy, David E.; Rampling, Roy; Erridge, Sara; Saran, Frank; Gattamaneni, Rao; Hopkins, Kirsten; Beall, Sarah L; Collins, V. Peter; Lee, Siow Ming

doi:10.1200/jco.2009.27.1932

Cited by 223 publications

(152 citation statements)

References 18 publications

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“…Somewhat better control rates at 6 months have been reported with a continuous dosing regimen of TMZ, 48 but not in recent phase II trial exploring a 21 out of 28 days schedule. 49 The BR12 trial which enrolled recurrent, TMZ-naïve malignant glioma patients provided no evidence for superiority of dose-intensified TMZ over standard-dosed TMZ, 50 but these data are of limited value in assessing the role of TMZ rechallenge for patients pre-exposed to TMZ. They do, however, suggest that there is no rationale for using dose-intensified TMZ in recurrent glioma patients who are TMZ-naive.…”

Section: Glioblastoma (Who Grade Iv)mentioning

confidence: 99%

EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma

Weller

Bent

Hopkins

et al. 2014

The Lancet Oncology

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684

532

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This guideline provides recommendations for diagnostic and therapeutic procedures for patients with malignant gliomas. We differentiate evidence-based standards from reasonable options or non-evidence-based measures that should no longer be considered. The recommendations herein should provide a framework and assurance for the choice of diagnostic procedures and therapeutic measures and aim to reduce complications from unnecessary treatment and cost. The guideline contributes to a critical appreciation of concurrent drugs with a focus on the controlled use of anticonvulsants and steroids. It should serve as a guideline for all professionals involved in the diagnostics and care of glioma patients and also as a source of knowledge for insurance companies and other institutions involved in the cost regulation of cancer care in Europe. Implementation of the recommendations summarised here will need interdisciplinary structures of care for patients with brain tumours and structured processes of diagnostic and therapeutic procedures. AF and DF report no conflicts of interest. FundingThe preparation of this guideline was not funded. The members of the task force did not receive compensation for their participation. 5 SummaryThis guideline provides recommendations for the diagnostic and therapeutic procedures for patients with malignant gliomas. It differentiates evidence-based standards from reasonable options or non-evidence-based measures that should no longer be considered. The recommendations herein shall provide a framework and assurance for the choice of diagnostic procedures and therapeutic measures and aim to reduce complications from unnecessary treatment and cost. The guideline will contribute to a critical appreciation of concurrent medications with a focus on the controlled use of anticonvulsants and steroids. It shall serve as a guideline for all professionals involved in the diagnostics and care of glioma patients and also as a source of knowledge for insurance companies and other institutions involved in the cost regulation of cancer care in Europe. Implementation of the recommendations summarized here will require interdisciplinary structures of care for brain tumor patients and structured processes of diagnostic and therapeutic procedures. Key wordsAnaplastic, glioma, glioblastoma, surgery, radiotherapy, temozolomide, bevacizumab Search strategy and selection criteriaThis guideline was prepared by a task force assembled by the Executive Committee of the European Association for Neuro-Oncology (EANO) in 2013. The task force was designed to represent the different disciplines involved in the diagnosis and care of malignant glioma patients as well as to reflect the multinational composition of EANO.References for this review were identified through searches of PubMed with the search terms "glioma", "anaplastic", "glioblastoma", "trial", "clinical", "radiotherapy" 6 and "chemotherapy" from January 2005 to January 2013. Articles were also identified through searches of the authors` own files. Onl...

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Section: Glioblastoma (Who Grade Iv)mentioning

confidence: 99%

EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma

Weller

Bent

Hopkins

et al. 2014

The Lancet Oncology

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684

532

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“…Beyond the randomized trial leading to the approval of TMZ mentioned above, two other randomized trials with TMZ monotherapy as one of the treatment arms have been published, a direct comparison with the combination of procarbazine, lomustine and vincristine (PCV) before TMZ became first-line standard [69] and a negative trial for the epidermal growth factor recetor (EGFR) tyrosine kinase inhibitor afatinib [70] ( Table 2 and The anti-vascular endothelial growth factor (VEGF) antibody bevacizumab [72][73][74][75], interferon-α2b [76], the multikinase inhibitor sorafenib [77], O6-benzylguanine [78], irinotecan [79], cisplatin [80,81], liposomal doxorubicine [82] and ABT-414, an EGFR-targeted antibody-drug conjugate conjugated to monomethylauristatin F [83].…”

Section: Temozolomide Monotherapy and Combination Regimensmentioning

confidence: 99%

Therapeutic options in recurrent glioblastoma—An update

Seystahl

Wick

Weller

2016

Critical Reviews in Oncology/Hematology

179

134

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“…A randomized trial comparing sdTMZ with procarbazine, in TMZ-naive patients, revealed a PFS6 of 21% versus 8%, with a median OS 1.5 months longer in the TMZ arm (127). Brada et al compared two different TMZ schedules with PCV, before TMZ became first-line standard, in patients with recurrent high-grade glioma (no separate data for GBM patients were provided) (166). In this trial, TMZ (both arms combined) did not display a clear benefit compared with PCV.…”

Section: Temozolomide Monotherapy and Combination Regimensmentioning

confidence: 90%

“…Four randomized phase II clinical trials were conducted using single-agent TMZ (127,159,166,167). A randomized trial comparing sdTMZ with procarbazine, in TMZ-naive patients, revealed a PFS6 of 21% versus 8%, with a median OS 1.5 months longer in the TMZ arm (127).…”

Section: Temozolomide Monotherapy and Combination Regimensmentioning

confidence: 99%

Current Standards of Care in Glioblastoma Therapy

et al. 2017

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Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Regardless of ideal multidisciplinary treatment, including maximal surgical resection, followed by radiotherapy plus concomitant and maintenance temozolomide (TMZ), almost all patients experience tumor progression with nearly universal mortality and a median survival of less than 15 months. The addition of bevacizumab to standard treatment with TMZ revealed no increase in overall survival (OS) but improved progression-free survival (PFS). In newly diagnosed GBM, methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter has been shown to predict response to alkylating agents, as well asgnosis. Therefore, MGMT promoter status may have a crucial role in the choice of single modality treatment in fragile elderly population. No standard of care is established in recurrent or progressive GBM. Treatment alternatives may include supportive care, surgery, re-irradiation, systemic therapies, and combined modality therapy. Despite numerous clinical trials, the identification of effective therapies is complex because of the lack of appropriate control arms, selection bias, small sample sizes, and disease heterogeneity. Tumor-treating fields plus TMZ represent a major advance in the field of GBM therapy, and should be Standards of Care in Glioblastoma Therapy 198 considered for patients with newly diagnosed GBM with no contraindications. As a disease with such a poor prognosis, treatment of GBM should go beyond improving survival and aim at preserving and even improving the quality of life of both the patient and the caregiver.

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Temozolomide Versus Procarbazine, Lomustine, and Vincristine in Recurrent High-Grade Glioma

Cited by 223 publications

References 18 publications

EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma

EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma

Therapeutic options in recurrent glioblastoma—An update

Current Standards of Care in Glioblastoma Therapy

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