Treating malignant glioma in Chinese patients: update on temozolomide

Abstract

Malignant glioma, ie, anaplastic astrocytoma and glioblastoma, is the most common type of primary malignant brain tumor in the People’s Republic of China, and is particularly aggressive. The median survival of patients with newly diagnosed glioblastoma is only 12–14 months despite advanced therapeutic strategies. Treatment of malignant glioma consists mainly of surgical resection followed by adjuvant radiation and chemotherapy. Temozolomide (TMZ), a second-generation oral alkylating agent, is playing an increasingly important role in the treatment of malignant glioma in Chinese patients. Since the publication of a study by Stupp et al in 2005, which used a protocol of conventional fractionated irradiation with concomitant TMZ followed by standard TMZ for six cycles, many clinical studies in the People’s Republic of China have demonstrated that such a treatment strategy has significantly improved efficacy with limited side effects for newly diagnosed glioblastoma after surgery as compared with strategies that do not contain TMZ. However, as a relatively new agent, the history and development of TMZ for malignant glioma is not well documented in Chinese patients. Multicenter, randomized controlled trials including appropriately sized patient populations investigating multiple aspects of TMZ therapy and related combination therapies are warranted in patients with malignant glioma. This review provides an update on the efficacy, mechanism of action, adverse reactions, and clinical role of TMZ in the treatment of malignant glioma in Chinese patients.

Anticancer activity of taraxerol acetate in human glioblastoma cells and a mouse xenograft model via induction of autophagy and apoptotic cell death, cell cycle arrest and inhibition of cell migration

“…The incidence rate of cancer in China is 1–4/100,000, with GBM being the most common type of primary brain tumor ( 5 ). Symptoms include headaches, epilepsy, dysphasia and cognitive change, which occur due to the extensive damage to healthy brain cells and tumor invasion ( 6 ). The treatment options for GBM are surgical removal of the local lesion, followed by adjuvant radio- and chemotherapy ( 7 , 8 ).…”

Nervous System and Intracranial Tumour Incidence by Ethnicity in England, 2001–2007: A Descriptive Epidemiological Study

“…The significantly lower incidence rate of glioma in Chinese compared to Whites has been reflected by other studies. For example, the incidence of malignant glioma among Hong Kong residents of Chinese origin has previously been shown to be 1/100,000 people[ 51 ], and the incidence of glioma in wider China is between 1-4/100,000 people[ 52 ]. This compares to an incidence of glioma between 4.67 and 5.73/100,000 people in Europe[ 53 – 55 ].…”

Opening the Blood-Brain Barrier and Improving the Efficacy of Temozolomide Treatments of Glioblastoma Using Pulsed, Focused Ultrasound with a Microbubble Contrast Agent

“…There is a grave need to explore a better therapeutic method to reduce the recrudescence rate and improve the quality of life of glioblastoma patients. Currently, the main therapeutic interventions for glioblastoma include surgical resection, radiation therapy, and chemotherapy [ 28 ]. Temozolomide is the most effective and commonly used chemotherapy drug in glioma treatment.…”