Is more better? The impact of extended adjuvant temozolomide in newly diagnosed glioblastoma: a secondary analysis of EORTC and NRG Oncology/RTOG.

Détails

ID Serval
serval:BIB_DD040065DB11
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Is more better? The impact of extended adjuvant temozolomide in newly diagnosed glioblastoma: a secondary analysis of EORTC and NRG Oncology/RTOG.
Périodique
Neuro-oncology
Auteur(s)
Blumenthal D.T., Gorlia T., Gilbert M.R., Kim M.M., Burt Nabors L., Mason W.P., Hegi M.E., Zhang P., Golfinopoulos V., Perry J.R., Hyun Nam D., Erridge S.C., Corn B.W., Mirimanoff R.O., Brown P.D., Baumert B.G., Mehta M.P., van den Bent M.J., Reardon D.A., Weller M., Stupp R.
ISSN
1523-5866 (Electronic)
ISSN-L
1522-8517
Statut éditorial
Publié
Date de publication
01/08/2017
Peer-reviewed
Oui
Volume
19
Numéro
8
Pages
1119-1126
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Radiation with concurrent and adjuvant (6 cycles) temozolomide (TMZ) is the established standard of postsurgical care for newly diagnosed glioblastoma (GBM). This regimen has been adopted with variations, including extending TMZ beyond 6 cycles. The optimal duration of maintenance therapy remains controversial.
We performed pooled analysis of individual patient data from 4 randomized trials for newly diagnosed GBM. All patients who were progression free 28 days after cycle 6 were included. The decision to continue TMZ was per local practice and standards, and at the discretion of the treating physician. Patients were grouped into those treated with 6 cycles and those who continued beyond 6 cycles. Progression-free and overall survival were compared, adjusted by age, performance status, resection extent, and MGMT methylation.
A total of 2214 GBM patients were included in the 4 trials. Of these, 624 qualified for analysis 291 continued maintenance TMZ until progression or up to 12 cycles, while 333 discontinued TMZ after 6 cycles. Adjusted for prognostic factors, treatment with more than 6 cycles of TMZ was associated with a somewhat improved progression-free survival (hazard ratio [HR] 0.80 [0.65-0.98], P = .03), in particular for patients with methylated MGMT (n = 342, HR 0.65 [0.50-0.85], P < .01). However, overall survival was not affected by the number of TMZ cycles (HR = 0.92 [0.71-1.19], P = .52), including the MGMT methylated subgroup (HR = 0.89 [0.63-1.26], P = .51).
Continuing TMZ beyond 6 cycles was not shown to increase overall survival for newly diagnosed GBM.
Mots-clé
Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Alkylating/therapeutic use, Brain Neoplasms/drug therapy, Combined Modality Therapy/methods, Dacarbazine/analogs & derivatives, Dacarbazine/therapeutic use, Disease Progression, Disease-Free Survival, Female, Glioblastoma/drug therapy, Humans, Male, Middle Aged, Tumor Suppressor Proteins/drug effects, adjuvant, glioblastoma, maintenance, temozolomide, treatment duration
Pubmed
Web of science
Open Access
Oui
Création de la notice
11/04/2017 17:32
Dernière modification de la notice
20/08/2019 16:01
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