Temozolomide As Initial Treatment for Adults With Low-Grade Oligodendrogliomas or Oligoastrocytomas and Correlation With Chromosome 1p Deletions

Hoang-Xuân, Khê; Laurent, Césari; Kujas, M.; Taillibert, Sophie; Duffau, Hugues; Lejeune, Julie; Polivka, Marc; Crinière, Emmanuelle; Marie, Yannick; Mokhtari, Karima; Carpentier, Alexandre; Laigle, F.; Simon, Julien; Cornu, Philippe; Broët, Philippe; Sanson, Marc; Delattre, J.

doi:10.1200/jco.2004.10.169

Cited by 332 publications

(210 citation statements)

References 27 publications

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“…Response categories were: -CR-complete response (disappearance of all tumour, off steroids and neurologically stable or improved); PR -partial response (50% or greater reduction in cross-sectional area, steroids stable or reduced, and neurologically stable or improved); PD -progressive disease (25% or greater increase in cross sectional area or any new tumour on CT/MR images and/or neurologically worse with steroids stable or increased); SD -stable disease (all other situations). In 10 nonenhancing cases and three for whom contrast enhancement was not assessable, response was assessed using T2-weighted images (Hoang-Xuan et al, 2004;Stege et al, 2005). An additional minor response (MR) category (425 -o50% reduction in cross-sectional area, steroids stable or reduced, and neurologically stable or improved) was included, as some cases showed radiological reduction in cross sectional T2W area of 425 -o50%, accompanied by clinical benefit.…”

Section: Response Assessmentmentioning

confidence: 99%

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

et al. 2006

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The À1p/À19q genotype predicts chemosensitivity in oligodendroglial neoplasms, but some with intact 1p/19q also respond and not all with 1p/19q loss derive durable benefit from chemotherapy. We have evaluated the predictive and prognostic significance of pretherapy 201 Tl and 18 F-FDG SPECT and genotype in 38 primary and 10 recurrent oligodendroglial neoplasms following PCV chemotherapy. 1p/19q loss was seen in 8/15 OII, 6/15 OAII, 7/7 OIII, 3/11 OAIII and was associated with response (FisherExact: P ¼ 0.000) and prolonged progression-free (log-rank: P ¼ 0.002) and overall survival (OS) (log-rank: P ¼ 0.0048). Response was unrelated to metabolism, with tumours with high or low metabolism showing response. Increased 18 F-FDG or 201 Tl uptake predicted shorter progression-free survival (PFS) in the series (log-rank: 201 Tl P ¼ 0.0097, 18 F-FDG P ¼ 0.0170) and in cases with or without the À1p/À19q genotype. Elevated metabolism was associated with shorter OS in cases with intact 1p/19q (log-rank: 18 F-FDG P ¼ 0.0077; 201 Tl P ¼ 0.0004) and shorter PFS in responders (log-rank: 18 F-FDG P ¼ 0.005; 201 Tl P ¼ 0.0132). 201 Tl uptake and 1p/19q loss were independent predictors of survival in multivariate analysis. In this initial study, 201 Tl and 18 F-FDG uptake did not predict response to PCV, but may be associated with poor survival following therapy irrespective of genotype. This may be clinically useful warranting further study.

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Section: Response Assessmentmentioning

confidence: 99%

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

et al. 2006

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“…Therefore, MRI cannot be used postoperatively after day 3 and for several weeks because the surgical damage of the BBB, with subsequent leakage of contrast media, leads to a false-positive indicator of the presence of residual or recurrent tumor. Moreover, conventional MRI techniques usually fail to detect early effects of radio-and chemotherapy because individual treatment effects are only visible after more than 12 months, [133][134][135] with a substantial interobserver variability in the assessment of treatment response. 136 Especially after the application of biologically active agents (gene therapy vectors, toxins), the value of conventional MRI to detect therapy-specific changes of tumor viability is limited 137 as reviewed previously.…”

Section: Imaging For Determination Of Treatment Effect Tumor Progresmentioning

confidence: 99%

Imaging in neurooncology

et al. 2005

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“…Quantification of PET and MR data was done using PMOD [12] on digitized images as described in detail in our recent publication [13]. For calculation of the MR tumor volume we used the FLAIR sequence which provides the best delineation between tumor and adjacent brain [3,14]. Following manual outlining of Wyss page 5 the tumor boundaries the areas of all tumor containing MR slices were summed up to yield the whole tumor volume.…”

Section: Patientsmentioning

confidence: 99%

“…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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Temozolomide As Initial Treatment for Adults With Low-Grade Oligodendrogliomas or Oligoastrocytomas and Correlation With Chromosome 1p Deletions

Abstract: TMZ is well tolerated and provides a substantial rate of response in LGOT. Chromosome 1p loss is correlated with radiographic response and could be a helpful marker for guiding therapeutic decision making in LGOT.

Cited by 332 publications

References 27 publications

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

Genetic and metabolic predictors of chemosensitivity in oligodendroglial neoplasms

Imaging in neurooncology

Early metabolic responses in temozolomide treated low-grade glioma patients

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