Addition of Temodar® to Radiation in Glioma: New Standard of Care
by Dr. C.H. Weaver M. D. updated 3/2019
The addition of the chemotherapy agent, Temodar® (temozolomide), to radiation therapy has demonstrated a huge survival benefit compared to treatment with radiation therapy alone among patients with newly diagnosed glioma. These results were recently presented at the annual meeting of the American Society of Clinical Oncology.
Gliomas refer to a class of brain cancers. There are several different types of gliomas, classified according to their degree of aggressiveness; their extent of spread; and certain cancer characteristics.
As treatment for cancer continues to progress, genetics has become an important part individualizing therapy. Patients with a type of glioma known as anaplastic glioma who have specific gene mutations referred to as 1p/19q co-deletions, tend to have improved survival and a greater sensitivity to treatment with chemotherapy.
Researchers recently conducted a clinical trial to evaluate the effectiveness of the addition of the chemotherapy agent, Temodar to radiation therapy in patients with newly diagnosed anaplastic glioma. The trial, referred to as the CATNON trial, included 748 patients with anaplastic glioma that did not have the 1p/19q co-deletions. One group of patients was treated with radiation only, while the other group was treated with radiation followed by Temodar. The median follow-up of patients was 27 months.
- At both 2 years and 5 years following initiation of therapy, overall survival was significantly improved among patients treated with the addition of Temodar, compared to those treated with radiation therapy only.
- Different groups in the study are also being evaluated for differences in outcomes depending upon when Temodar was initiated (ie, delivered during radiation therapy)
- Molecular markers are also being evaluated in subgroup analyses to further clarify exactly which patients benefit the most from the addition of chemotherapy.
The researchers concluded that the addition of Temodar after radiation therapy significantly improved long-term survival compared to radiation therapy only among newly diagnosed patients with anaplastic glioma without the 1p/19q co-deletion, and could be considered the new standard of care for treatment of this disease.
Reference: Van Den Bent M, Erridge S, Vogelbaum M, et al. Results of the interim analysis of the EORTC randomized phase III CATNON trial on concurrent and adjuvant temozolomide in anaplastic glioma without 1p/19q co-deletion: An Intergroup trial. Presented at the 2016 annual meeting of the American Society of Clinical Oncology. Late-breaking abstract (LBA) 2000. Available at: Results of the interim analysis of the EORTC randomized phase III CATNON trial on concurrent and adjuvant temozolomide in anaplastic glioma without 1p/19q co-deletion: An Intergroup trial.. Accessed January 4, 2017.