Journal
CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS
Volume 12, Issue 3, Pages 286-293Publisher
SPRINGER
DOI: 10.1007/s11910-012-0262-y
Keywords
Chemotherapy; Glioblastoma; Temozolomide; Nitrosourea; MGMT
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Funding
- Medac GmbH
- Novartis
- Mundipharma
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Even in modern times of high-precision brain surgery and irradiation, malignant gliomas belong to the deadliest types of cancer. Due to a marked primary and presumably also acquired resistance, the beneficial effects of cytotoxic chemotherapy are limited. Only one randomized clinical trial demonstrated a significant impact on overall survival with temozolomide. Ever since, there have been attempts to improve the efficacy of alkylating chemotherapy by modulating the distribution of dose in time aiming at a better treatment success. Apart from higher cumulative doses per cycle, better efficacy by depletion of the anti-alkylating O-6-methylguanine-DNA methyltransferase (MGMT) protein has been a major goal of these regimens. After promising results of single-arm pilot studies, however, randomized studies have been disappointing so far. In this overview, the different strategies of dose-dense temozolomide regimen are highlighted and results of clinical trials put into perspective.
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