Phase II Trial of Temozolomide in Patients With Progressive Low-Grade Glioma

Quinn, Jennifer A.; Reardon, David A.; Friedman, Allan H.; Rich, Jeremy; Sampson, John H.; Provenzale, James M.; McLendon, Roger E.; Gururangan, Sridharan; Bigner, Darell D.; Herndon, James E.; Avgeropoulos, Nicholas G.; Finlay, Jonathan L.; Tourt-Uhlig, Sandra; Affronti, Mary Lou; Evans, Bruce; Stafford-Fox, Valerie; Zaknoen, Sara

doi:10.1200/jco.2003.01.009

Cited by 235 publications

(127 citation statements)

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“…Although the majority of patients with OPG have an indolent or asymptomatic course, numerous studies have documented symptomatic progression of OPGs such that treatment was necessary to preserve vision or life. [14][15][16][17][18][19][20][21] …”

Section: Discussionmentioning

confidence: 99%

“…Carboplatin, cisplatin, vincristine, vinblastine, actinomycin D, lomustine, thioguanine, procarbazine, dibromodulcitol, etoposide, tamoxifen, and temozolomide, alone or in combination, as primary treatment or as adjuvant, have all been utilized. [10][11][12][13]19,[32][33][34][35][36][37][38][39][40] Although chemotherapy has emerged as promising therapy, no regimen has yet to be universally accepted, hence the current Children's Oncology Group trial.…”

Section: Treatmentmentioning

confidence: 99%

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Optic glioma warranting treatment in children

Kaufman

Doroftei

2006

Eye

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Purpose To describe cases of optic pathway glioma (OPG) warranting treatment in children. Methods This is a retrospective review of pediatric patients treated for OPG. The clinical data and imaging studies were obtained from the medical records and radiology files of patients seen at the Pediatric NeuroOphthalmology Clinic at the University of Illinois, Chicago and the private office of the author (LMK). Results A total of seven cases with an age range of 3-48 months at presentation were reviewed. Three of the patients were also ultimately diagnosed with neurofibromatosis type 1. Presenting symptoms included proptosis, decreased vision, gaze deficit, and nystagmus. Four patients underwent biopsies that confirmed OPG. Six of the patients were treated with intravenous chemotherapy, with three patients requiring a second chemotherapy cycle. One patient was successfully treated with an en-bloc optic nerve excision. Two patients underwent unilateral enucleation owing to globe complications. Conclusion Although benign tumours, OPG can behave very aggressively in young children. Both chemotherapy and en-bloc excision can be employed for treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Optic glioma warranting treatment in children

Kaufman

Doroftei

2006

Eye

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“…In two phase II trials of TMZ in heavily pre-treated patients the treatment was safe and well tolerated and showed clinical activity in patients with BrMs from NSCLC [21,22]. In 52 patients, with progressive brain metastases after WBRT, three partial responses (two in lung cancer patients and one in patient with melanoma) were reported with TMZ by Friedman et al [23]. For newly diagnosed brain metastases, a preliminary report by Siena et al…”

Section: Discussionmentioning

confidence: 99%

Oral temozolomide in heavily pre-treated brain metastases from non-small cell lung cancer: Phase II study

Giorgio¹,

Giuffrida²,

Pappalardo³

et al. 2005

Lung Cancer

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Summary Introduction:The primary tumour type most likely to metastasize to the brain is lung cancer. In heavily pre-treated patients, limited therapeutic option is available and the results of availability therapies reported in literature are disappointing. The present phase II study was designed to assess the efficacy and safety of temozolomide (TMZ) as palliative treatment for brain metastases (BrM) in NSCLC patients pre-treated with WBRT and at least one line of chemotherapy for metastatic brain disease. Material and methods: Temozolomide was administered orally at 150 mg/mq/day for five consecutive days for the first cycle, doses were increased to 200 mg/mq/day for 5 days every 28 days for subsequent cycles if no grade 3/4 haematological toxicity was observed. Eligibility criteria included cytological or histological confirmed NSCLC; BrM, recurrent or progressing after WBRT and at least one line of chemotherapy. A total of 30 consecutive patients entered the study and received the allocated treatment.Results: Three patients (10%) achieved an objective response (OR) of BrM with two complete remission. Stable disease and progressive disease were achieved in 3 (10%) and 24 patients (80%), respectively. A correlation between response to TMZ * Corresponding author. and sensitivity to the previous first line chemotherapy was reported. Time to progression and overall survival were examined both for responder patients and for all included patients. For long-term survivors, we considered the patients who survived >12 months after the start of TMZ. According to this definition, three patients resulted long-term survivors: 2 with OR and 1 with stable brain disease. No grades 3 or 4 toxicity occurred. The total of treatment-related adverse events were mild or moderate (G1-2) in intensity. No patients discontinued TMZ as a result of treatment-related toxicity. Discussion: The results of the present trial clearly demonstrates that TMZ is active and safe in BrM NSCLC patients previously treated with WBRT and at least one line of chemotherapy.

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“…imaging chemotherapy yielded response rates up to 61% [2][3][4][5][6] which were mainly determined by Macdonald`s criteria [7], although these criteria are not validated for…”

Section: Introductionmentioning

confidence: 99%

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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Phase II Trial of Temozolomide in Patients With Progressive Low-Grade Glioma

Abstract: Initial results indicate that Temodar may be active in the treatment of low-grade glioma, and thus, further evaluation of this agent in the treatment of these tumors is warranted.

Cited by 235 publications

References 34 publications

Optic glioma warranting treatment in children

Optic glioma warranting treatment in children

Oral temozolomide in heavily pre-treated brain metastases from non-small cell lung cancer: Phase II study

Early metabolic responses in temozolomide treated low-grade glioma patients

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