Dose-dense temozolomide for recurrent high-grade gliomas: a single-center retrospective study

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From: Medical Oncology(Vol. 35, Issue 10)
Publisher: Springer
Document Type: Report
Length: 430 words

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To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s12032-018-1198-0 Byline: Catherine R. Garcia (6), Stacey A. Slone (6), Rachael M. Morgan (4), Lindsey Gruber (4), Sameera S. Kumar (5,6), Donita D. Lightner (2), John L. Villano (1,2,3,6) Keywords: High-grade gliomas; Recurrence; Dose-dense temozolomide; Prognosis Abstract: There are limited treatment modalities after high-grade gliomas recurrence. MGMT depletion modulated by dose-dense temozolomide (ddTMZ) remains a debated therapy for initial TMZ responders. Patients were selected retrospectively from our practice with diagnosis of high-grade gliomas (WHO grade III or IV), and were followed since the start of ddTMZ until death or change of therapy. Twenty-one patients were reviewed, with a median age of 47 (25--61) years and a median of 5.8 (1.5--38.8) cycles of ddTMZ. The majority were males (71.4%). Sixty-six percent received 21 on/28 off ddTMZ schedule, 28.6% daily, and 1 patient received a 7 days on/7 days off schedule. IDH mutation status was available for 18 (85.7%) patients, with 7 (33.3%) IDH mutant and 11 (52.5%) IDH wild type. MGMT methylation was assessed in 6 (28.6%) of the patients, being MGMT methylated in 3 (14.3%) patients, and non-methylated in 3 (14.3%) patients. The majority of patients (57.1%) were receiving ddTMZ in addition to other forms of therapy, including either bevacizumab (38.1%) or tumor-treating fields (TTFields) (19.1%). Overall ddTMZ was well tolerated, with few adverse events reported. The estimated median overall survival after ddTMZ start was 11 months. Median progression-free survival (PFS) was 6 months. Outcomes did not vary between patients receiving ddTMZ alone or those using TTFields or bevacizumab as concomitant therapy, but there was a trend to longer survival with the use of concomitant TTFields. Our results demonstrate benefit of ddTMZ after previous treatment with standard TMZ dosing with no apparent increase in treatment-related toxicities. In summary, ddTMZ should be considered in TMZ responsive patients and warrants further investigation. Author Affiliation: (1) 0000 0004 1936 8438, grid.266539.d, Department of Medicine, University of Kentucky, Lexington, KY, USA (2) 0000 0004 1936 8438, grid.266539.d, Department of Neurology, University of Kentucky, Lexington, KY, USA (3) 0000 0004 1936 8438, grid.266539.d, Department of Neurosurgery, University of Kentucky, 800 Rose St., CC446, Lexington, KY, 40536-0093, USA (4) 0000 0004 1936 8438, grid.266539.d, Department of Clinical Oncology Pharmacy, University of Kentucky, Lexington, KY, USA (5) 0000 0004 1936 8438, grid.266539.d, Department of Radiation Medicine, University of Kentucky, Lexington, KY, USA (6) 0000 0004 1936 8438, grid.266539.d, Markey Cancer Center, University of Kentucky, Lexington, KY, USA Article History: Registration Date: 22/08/2018 Received Date: 15/07/2018 Accepted Date: 22/08/2018 Online Date: 28/08/2018

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Gale Document Number: GALE|A552147258