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Clinical Trial Suggests Temozolomide-Based Chemoradiation Is Best for Low-Grade Brain Tumors

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Key Points

  • Patients with low-grade gliomas have an overall survival of 73% after 3 years when treated with radiation plus temozolomide.
  • Three-year survival is 54% for historical controls treated with radiation alone.
  • The 3-year progression-free survival rate of participants in the study was 59%.

New clinical trial findings provide further evidence that combining chemotherapy with radiation therapy is the best treatment for people with a low-grade form of brain cancer. The findings come from a phase II study co-led by a researcher at Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC—James). The findings were published by Fisher et al in the International Journal of Radiation Oncology Biology Physics.

Chemoradiation vs Radiation Alone

The study shows that patients with low-grade gliomas have an overall survival of 73% after 3 years when treated with radiation plus temozolomide. This is compared with a 3-year survival of 54% for historical controls treated with radiation alone.

“The most effective treatment for these rare tumors is currently controversial at best,” said Arnab Chakravarti, MD, Chair and Professor of Radiation Oncology and Codirector of the Brain Tumor Program at the OSUCCC – James.

“Many of these high-risk, low-grade gliomas progress to grade III and IV tumors over time, so identifying the best treatment strategy is critical to ensure that patients have the best outcomes,” said Dr. Chakravarti, who is also the Max Morehouse Chair in Cancer Research at Ohio State.

“Our study reports that combining radiation with temozolomide-based chemotherapy appears to improve clinical outcome compared to historical controls treated by radiation alone. This may prove critical in killing enough of these tumor cells, so that they do not progress to glioblastoma multiforme over time.”

Study conclusions include the 3-year progression-free survival rate of 59%, while grade 3 adverse events occurred in 43% of patients. Grade 4 events occurred in 10% of patients.

Dr. Chakravarti and his laboratory are currently conducting molecular studies to more specifically identify which low-grade glioma patients benefit from temozolomide.

Barbara J. Fisher, MD, is the corresponding article for the International Journal of Radiation Oncology Biology Physics article.

This study was supported by the National Institutes of Health/National Cancer Institute. For a full list of authors and disclosures, visit www.redjournal.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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