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The use of temozolomide as a radiosensitiser for the treatment of newly diagnosed glioblastoma multiforme

Published online by Cambridge University Press:  01 June 2007

N. Walsh  and
A. Fleet
N. Walsh*
Affiliation:
Medical Physics Department, Cromwell Hospital, London, UK
A. Fleet
Affiliation:
Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield, UK
*
Correspondence to: Nadia Walsh, Deputy Planning Supervisor, Medical Physics Department, Cromwell Hospital, London SW5 0TU, UK. E-mail: Nadia.Walsh@cromwellhospital.com
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Abstract

Glioblastoma multiforme (GBM) is the most commonly occurring adult brain tumour and has the worst prognosis. Radiobiologically, GBM exhibits radioresistant characteristics, which may contribute to its incurability. The use of a chemical radiosensitiser combined with radiotherapy may be an exploitable mechanism to improve therapeutic gain. Temozolomide (TMZ) is a promising new alkylating agent that has been introduced into clinical practice over the last decade and has shown modest activity against high-grade gliomas. This paper aims to evaluate the evidence base for the use of TMZ as a radiosensitiser in practice by reviewing published literature. Findings demonstrate promising improvements in progression-free and overall survival for patients with GBM receiving concomitant and adjuvant TMZ and radiotherapy compared with radiotherapy alone. These results are evaluated to put forth recommendations for further research.

Keywords

Gliomaradiotherapytemozolomide
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 6 , Issue 2 , June 2007 , pp. 103 - 110
Copyright
Copyright © Cambridge University Press 2007

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References

Stupp, R, Gander, M, Leyvraz, S, Newlands, E.Current and future developments in the use of temozolomide for the treatment of brain tumours. Lancet Oncol 2001; 2:552–560.CrossRefGoogle ScholarPubMed
Uddin ABM Salah, Jarmi T, Hariharan S. Glioblastoma multiforme 2005 [online]. Last accessed on 28 March 2006 at http://www.emedicine.com.Google Scholar
Rees, JH, Smirniotopoulos, JG, Jones, RV, Wong, K.Glioblastoma multiforme: radiologic-pathologic correlation. RadioGraphics 1996; 16:1413–1438.CrossRefGoogle ScholarPubMed
Lonardi, S, Tosoni, A, Brandes, AA.Adjuvant chemotherapy in the treatment of high grade gliomas. Cancer Treat Rev 2005; 31: 79–89.CrossRefGoogle ScholarPubMed
Bomford, CK, Kunkler, IH.Walter and Miller’s textbook of radiotherapy. 6th edition. Churchill Livingstone, 2003.Google Scholar
Horsman, MR, Overgard, J. The oxygen effect and tumour microenvironment. In: Steel, GG (ed). Basic Clinical Radiobiology. 3rd edition. London: Arnold, 2002, pp. 158–168.Google Scholar
Stewart, FA, Bartelink, H. The combination of radiotherapy and chemotherapy. In: Steel, GG (ed). Basic Clinical Radiobiology. 3rd edition. London: Arnold, 2002, pp. 217–230.Google Scholar
Electronic Medicines Compendium (eMC). Temodal SPC [online]. Last updated 15 December 2005. Last accessed on 24 April 2006 at http://emc.medicines.org.uk.Google Scholar
Newlands, ES, Stevens, MFG, Wedge, SR, Wheelhouse, RT, Brock, C.Temozolomide: a review of its discovery, chemical properties, pre-clinical development and clinical trials. Cancer Treat Rev 1997; 23:35–61.CrossRefGoogle ScholarPubMed
van Rijn, J, Heimans, JJ, van den Berg, J, van der Valk, P, Slotman, BJ.Survival of human glioma cells treated with various combination of temozolomide and x-rays. Int J Rad Oncol Biol Phys 2000; 47:779–784.CrossRefGoogle ScholarPubMed
Hirose, Y, Berger, MS, Pieper, RO.p53 effects both the duration of G2/M arrest and the fate of temozolomide-treated human glioblastoma cells. Cancer Res 2001; 61:1957–1963.Google ScholarPubMed
Brock, CS, Newlands, ES, Wedge, SR, Bower, M, Evans, H, Colquhoun, I, Roddie, M, Glaser, M, Brampton, MH, Rustin, GJ.Phase I trial of temozolomide using an extended continuous oral schedule. Cancer Res 1998; 58:4363–4367.Google ScholarPubMed
Stupp, R, Dietrich, PY, Kraljevic, SO, et al. . Promising survival for patients with newly diagnosed glioblastoma multiforme treated with concomitant radiation plus temozolomide followed by adjuvant temozolomide. J Clin Oncol 2002; 20:1375–1382.Google Scholar
Hegi, ME, Diserens, AC, Godard, S, Dietrich, PY, Regli, L, Ostermann, S, Otten, P, Van Melle, G, de Tribolet, N, Stupp, R.Clinical trial substantiates the predictive value of O-6-methylguanine-DNA methyltransferase promoter methylation in glioblastoma patients treated with temozolomide. Clin Cancer Res 2004; 10:1871–1874.Google Scholar
Yung, WK, Albright, RE, Olson, J, et al. . A phase II study of temozolomide vs. procarbazine in patients with glioblastoma multiforme at first relapse. Br J Cancer 2000; 83:588–593.CrossRefGoogle ScholarPubMed
Great Britain, Department of Health. Guidance on the use of temozolomide for the treatment of recurrent malignant glioma (brain cancer). National Institute for Clinical Excellence. Department of Health 2001.Google Scholar
Stupp, R, Mason, WP, van den Bent, MJ, et al. . Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005; 352:987–996.Google Scholar
Chibbaro, S, Benvenuti, L, Caprio, A, et al. . Temozolomide as a first-line agent in treating high-grade gliomas: phase II study. J Neurooncol 2004; 67:77–81.CrossRefGoogle ScholarPubMed
Combs, SE, Gutwein, S, Schulz-Ertner, D, van Kampen, M, Thilmann, C, Edler, L, Wannenmacher, MM, Debus, J.Temozolomide combined with irradiation as postoperative treatment of primary glioblastoma multiforme. Phase I/II study. Strahlenther Onkol 2005; 181: 372–377.CrossRefGoogle ScholarPubMed
Franceschi, E, Omuro, AMP, Lassman, AB, Demopoulos, A, Nolan, C, Abrey, LE.Salvage temozolomide for prior temozolomide responders. Cancer 2005; 104:2473–2476.CrossRefGoogle ScholarPubMed
Gilbert, MR, Friedman, HS, Kuttesch, JF, Prados, MD, Olson, JJ, Reaman, GH, Zaknoen, SL. A phase II study of temozolomide in patients with newly diagnosed supratentorial malignant glioma before radiation therapy. Neuro-Oncol 2002; 4:261–267.CrossRefGoogle ScholarPubMed
Brada, M, Ashley, S, Dowe, A, et al. . Neoadjuvant phase II multicentre study of new agents in patients with malignant glioma after minimal surgery. Report of a cohort of 187 patients treated with temozolomide. Ann Oncol 2005; 16:942–949.Google ScholarPubMed
Jung, SH, Lee, T, Kim, KM, George, SL. Admissible two-stage designs for phase II cancer clinical trials. Stat Med 2004; 23:561–569.CrossRefGoogle ScholarPubMed
Brandes, AA, Vastola, F, Basso, U, Berti, F, Pinna, G, Rotilio, A, Gardiman, M, Scienza, R, Monfardini, S, Ermani, M. A prospective study on glioblastoma in the elderly. Cancer 2003; 97:657–662.Google Scholar
Wasserfallen, JB, Ostermann, S, Pica, A, Mirimanoff, RO, Leyvraz, S, Villemure, JG, Stupp, R. et al. . Can we afford to add chemotherapy to radiotherapy for glioblastoma multiforme? Cost-identification analysis of concomitant and adjuvant treatment with temozolomide until patient death. Cancer 2004; 101:2098–2105.CrossRefGoogle ScholarPubMed
Martikainen, JA, Kivioja, A, Hallinen, T, Vihinen, P.Economic evaluation of temozolomide in the treatment of recurrent glioblastoma multiforme. Pharmacoeconomics 2005; 23:803–815.CrossRefGoogle ScholarPubMed
Dinnes, J, Cave, C, Huang, S, Major, K, Milne, R. The effectiveness and cost-effectiveness of temozolomide for the treatment on recurrent malignant glioma: a rapid and systematic review. Health Technology Assessment NHS R&D HTA Programme report 2001; 5(13).Google ScholarPubMed
Xu, GW, Mymryk, JS, Cairncross, JG. Inactivation of p53 sensitises astrocytic glioma cells to BCNU and temozolomide, but not cisplatin. J Neurooncol, 2005; 74:141–149. Google Scholar