Dynamic history of low‐grade gliomas before and after temozolomide treatment

Ricard, Damien; Kaloshi, Gentian; Amiel-Benouaich, Alexandra; Lejeune, Julie; Marie, Yannick; Mandonnet, Emmanuel; Kujas, M.; Mokhtari, Karima; Taillibert, Sophie; Laigle‐Donadey, Florence; Carpentier, Antoine F.; Omuro, Antonio; Laurent, Césari; Duffau, Hugues; Cornu, Philippe; Guillevin, Rémy; Sanson, Marc; Hoang-Xuân, Khê; Delattre, Jean‐Yves

doi:10.1002/ana.21125

Cited by 186 publications

(120 citation statements)

References 9 publications

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“…[22][23][24][25][26][27] Strategies to improve TMZ effectiveness, such as extended or dose-intense TMZ schedules, the blockade of alkylation DNA repair (ie, using alkyl guanine transferase suicide substrates), or the inhibition of base excision repair, are being evaluated for intracranial gliomas, and may be adapted for the treatment of spinal cord gliomas. [28][29][30] Increasingly, clinical trials of intracranial gliomas stratify patients based on tumor content of the DNA repair enzyme O 6 methylguanine-DNA methyltransferase (MGMT).…”

Section: Discussionmentioning

confidence: 99%

Temozolomide for recurrent low‐grade spinal cord gliomas in adults

Chamberlain

2008

Cancer

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BACKGROUND.There is no standard therapy for surgery‐ and radiotherapy‐resistant, recurrent, low‐grade spinal cord gliomas. Therefore, a retrospective study of temozolomide (TMZ) in adults with recurrent low‐grade spinal cord gliomas with a primary objective of determining progression‐free survival (PFS) was performed.METHODS.Twenty‐two patients (11 men and 11 women) aged 20 years to 55 years (median, 35 years) with recurrent spinal cord gliomas (World Health Organization grade 2 astrocytoma in 19 patients and oligoastrocytoma in 3 patients) were treated. All had previously been treated with surgery and involved‐field radiotherapy. Thirteen patients underwent repeat surgery. All patients were chemotherapy–naive. TMZ was administered at a dose of 150‐200 mg/m2/day for 5 consecutive days every 4 weeks (operationally defined as a single cycle). Neurologic and neuroradiographic evaluations were performed every 8 weeks.RESULTS.All patients were evaluable for toxicity and response. A total of 266 cycles of TMZ (median, 14 cycles; range, 2 cycles‐24 cycles) was administered. TMZ‐related toxicity included constipation (9 patients, 1 with grade 3), lymphopenia (9 patients, 1 with grade 3), fatigue (7 patients, 1 with grade 3), neutropenia (6 patients, 2 with grade 3), and thrombocytopenia (6 patients, 2 with grade 3). Four (18%) patients demonstrated a partial radiographic response, 12 (55%) demonstrated stable disease, and 6 (27%) had progressive disease after 2 cycles of TMZ. Time to tumor progression ranged from 2 months to 28 months (median, 14.5 months). Survival ranged from 4 months to 39 months (median, 23 months). PFS at 6 months, 12 months, 18 months, and 24 months was 64%, 64%, 41%, and 27%, respectively.CONCLUSIONS.TMZ demonstrated modest efficacy with acceptable toxicity in this cohort of adult patients with recurrent low‐grade spinal cord gliomas. Cancer 2008. © 2008 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Temozolomide for recurrent low‐grade spinal cord gliomas in adults

Chamberlain

2008

Cancer

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“…This view was corroborated by studies that suggested that ODs have a more indolent behavior, even prior to the initiation of treatment [8,10]. Indeed, a study measuring growth speed in lowgrade gliomas observed a slower growth rate in 1p/19q codeleted ODs [49]. However, in a recent study of untreated low-grade ODs and AOTs, on multivariate analysis, the presence of 1p and 19q loss was found not to be prognostic for progression-free survival [20].…”

Section: Is 1p/19q Codeletion Predictive Of Outcome To Chemotherapy mentioning

confidence: 99%

Oligodendrogliomas: Molecular Biology and Treatment

Bromberg

Bent

2009

The Oncologist

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The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. Target audience:Physicians who wish to advance their current knowledge of clinical cancer medicine in neuro-oncology. LEARNING OBJECTIVES1. Evaluate the current challenges in the histological diagnosis of oligodendroglial tumors and apply best practices to optimize patient outcomes.2. Analyze the molecular alterations in different subsets of tumors with oligodendroglial morphology.3. Formulate treatment options for your patients with newly diagnosed and recurrent oligodendroglial tumors.This article is available for continuing medical education credit at CME.TheOncologist.com. The Oncologist CME Program is located online at http://cme.theoncologist.com/. To take the CME activity related to this article, you must be a registered user. CME CME ABSTRACT Neuro-OncologyThe Oncologist

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“…A mean tumor diameter increase of 4.1mm per year was reported in oligodendrogliomas or mixed gliomas on serial MR [17]. TMZ chemotherapy reversed this increase and led to an average tumor diameter decrease of 9.1 mm per year in one series [18]. The key finding of our study is that a 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 Wyss page 9 time points (figure 3) suggests that metabolic responses may be observed as early as one month after treatment initiation.…”

Section: Discussionmentioning

confidence: 79%

Early metabolic responses in temozolomide treated low-grade glioma patients

et al. 2009

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(MR). A homogeneous population of 11 patients with progressive non-enhancing LGG was prospectively studied. Imaging was done at 6-months intervals starting six months, and in a second series starting three months after treatment initiation. F-18 fluoro-ethyl-l-tyrosine (FET) uptake was quantified with PET as metabolically active tumor volume, and was compared with the tumor volume on MR. Response was defined as ≥10% reduction of the initial tumor volume. Eight patients showed metabolic responses. Already 3 months after start of chemotherapy the active FET volumes decreased in 2 patients to a mean of 44% from baseline. First MR volume responses were noted at 6 months. Responders showed a volume reduction to 31 ± 23% (mean ± SD) from baseline for FET, and to 73 ± 26% for MR. The time to maximal volume reduction was 8.0 ± 4.4 months for FET, and 15.0 ± 3.0 months for MR. The initial metabolic response correlated with the best volume response on MR (Spearman Rank P = 0.011). Deactivation of amino acid transport represents an early indicator of chemotherapy response in LGG. Response assessment based on MR only has to be reconsidered. The time window obtained from PET may assist for individual treatment decisions in LGG patients. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 Wyss page 2 AbstractBackground: Amino acid transport and protein synthesis are important steps of tumor

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Dynamic history of low‐grade gliomas before and after temozolomide treatment

Cited by 186 publications

References 9 publications

Temozolomide for recurrent low‐grade spinal cord gliomas in adults

Temozolomide for recurrent low‐grade spinal cord gliomas in adults

Oligodendrogliomas: Molecular Biology and Treatment

Early metabolic responses in temozolomide treated low-grade glioma patients

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