THE CHARING-CROSS-HOSPITAL EXPERIENCE WITH TEMOZOLOMIDE IN PATIENTS WITH GLIOMAS

Temozolomide, a new oral cytotoxic agent, was given to 75 patients wit h malignant gliomas. The schedule used was for the first course 150 mg /m(2) per day for 5 days (i.e. total dose 750 mg/m(2)), escalating, if no significant myelosuppression was noted on day 22, to 200 mg/m(2) p er day for 5 days (i.e. total dose 1000 mg/m(2)) for subsequent course s at 4-week intervals. There were 27 patients with primary disease tre ated with two courses of temozolomide prior to their radiotherapy and 8 (30%) fulfilled the criteria for an objective response. There were 4 8 patients whose disease recurred after their initial surgery and radi otherapy and 12 (25%) fulfilled the criteria for an objective response . This gave an overall objective response rate of 20 (27%) out of 75 p atients. Temozolomide was generally well tolerated, with little subjec tive toxicity and predictable myelosuppression. However, the responses induced with this schedule were of short duration and had relatively little impact on overall survival. In conclusion, temozolomide given i n this schedule has activity against high grade glioma. However, studi es evaluating chemotherapy in primary brain tumours should include a q uality-of-life/performance status evaluation in addition to CT or MRI scanning assessment. Copyright (C) 1996 Elsevier Science Ltd