Up-front temozolomide in elderly patients with anaplastic oligodendroglioma and oligoastrocytoma
Optimal treatment of anaplastic oligodendroglial tumors (AOT) in elderly patients is debatable. We report a retrospective study of 44 consecutive patients aged 70 years or older [median age: 74 years; median Karnofsky performance status (KPS): 70] treated with up-front chemotherapy using temozolomid...
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| Veröffentlicht in: | Journal of neuro-oncology 2011-02, Vol.101 (3), p.457-462 |
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| creator | Ducray, François Sierra del Rio, Monica Carpentier, Catherine Psimaras, Dimitri Idbaih, Ahmed Dehais, Caroline Kaloshi, Gentian Mokhtari, Karima Taillibert, Sophie Laigle-Donadey, Florence Omuro, Antonio Sanson, Marc Delattre, Jean-Yves Hoang-Xuan, Khê |
| description | Optimal treatment of anaplastic oligodendroglial tumors (AOT) in elderly patients is debatable. We report a retrospective study of 44 consecutive patients aged 70 years or older [median age: 74 years; median Karnofsky performance status (KPS): 70] treated with up-front chemotherapy using temozolomide (TMZ) at conventional doses until tumor progression. O
6
-methylguanine-DNA methyltransferase promoter (MGMTP) methylation was assessed in 38 patients. Of the 41 evaluable patients, partial response (PR) was seen in 13 (32%) patients, 17 (41%) patients achieved stable disease, while the disease progressed in 11 (27%) patients. Median progression-free survival (PFS) and overall survival (OS) were 6.9 and 12.4 months, respectively. Hematoxicity grades 3–4 occurred in nine patients (20%). MGMTP was methylated in 50% of patients and was associated with both longer PFS (8.7 versus 5.7 months,
P
= 0.01) and longer OS (16.1 versus 12.4 months,
P
= 0.05). The rate of responders to chemotherapy was similar in MGMTP-methylated (38%) and in MGMTP-unmethylated patients (31%), but duration of response was significantly longer in responders with methylated MGMTP than in responders with unmethylated MGMTP (16.1 versus 9.6 months,
P
= 0.0004). This study demonstrates that a substantial number of elderly patients with AOT can achieve prolonged survival with up-front chemotherapy using TMZ. Further investigation is needed to determine whether this treatment is preferable to initial radiation therapy. |
| doi_str_mv | 10.1007/s11060-010-0264-z |
| format | Article |
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6
-methylguanine-DNA methyltransferase promoter (MGMTP) methylation was assessed in 38 patients. Of the 41 evaluable patients, partial response (PR) was seen in 13 (32%) patients, 17 (41%) patients achieved stable disease, while the disease progressed in 11 (27%) patients. Median progression-free survival (PFS) and overall survival (OS) were 6.9 and 12.4 months, respectively. Hematoxicity grades 3–4 occurred in nine patients (20%). MGMTP was methylated in 50% of patients and was associated with both longer PFS (8.7 versus 5.7 months,
P
= 0.01) and longer OS (16.1 versus 12.4 months,
P
= 0.05). The rate of responders to chemotherapy was similar in MGMTP-methylated (38%) and in MGMTP-unmethylated patients (31%), but duration of response was significantly longer in responders with methylated MGMTP than in responders with unmethylated MGMTP (16.1 versus 9.6 months,
P
= 0.0004). This study demonstrates that a substantial number of elderly patients with AOT can achieve prolonged survival with up-front chemotherapy using TMZ. Further investigation is needed to determine whether this treatment is preferable to initial radiation therapy.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-010-0264-z</identifier><identifier>PMID: 20556480</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Aged ; Aged, 80 and over ; Antineoplastic Agents, Alkylating - pharmacology ; Brain Neoplasms - drug therapy ; Brain Neoplasms - genetics ; Brain Neoplasms - pathology ; Clinical Study – Patient Study ; Dacarbazine - analogs & derivatives ; Dacarbazine - pharmacology ; DNA Methylation ; DNA Modification Methylases - genetics ; DNA Repair Enzymes - genetics ; DNA, Neoplasm - genetics ; Female ; Follow-Up Studies ; Humans ; Male ; Medicine ; Medicine & Public Health ; Neurology ; Oligodendroglioma - drug therapy ; Oligodendroglioma - genetics ; Oligodendroglioma - pathology ; Oncology ; Polymerase Chain Reaction ; Promoter Regions, Genetic - genetics ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Tumor Suppressor Proteins - genetics</subject><ispartof>Journal of neuro-oncology, 2011-02, Vol.101 (3), p.457-462</ispartof><rights>Springer Science+Business Media, LLC. 2010</rights><rights>Springer Science+Business Media, LLC. 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c402t-362f67c2be2a3c0df8603c2b384ae1991a6f6a94c7f89d053afbfd32796d66183</citedby><cites>FETCH-LOGICAL-c402t-362f67c2be2a3c0df8603c2b384ae1991a6f6a94c7f89d053afbfd32796d66183</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11060-010-0264-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11060-010-0264-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27902,27903,41466,42535,51296</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20556480$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ducray, François</creatorcontrib><creatorcontrib>Sierra del Rio, Monica</creatorcontrib><creatorcontrib>Carpentier, Catherine</creatorcontrib><creatorcontrib>Psimaras, Dimitri</creatorcontrib><creatorcontrib>Idbaih, Ahmed</creatorcontrib><creatorcontrib>Dehais, Caroline</creatorcontrib><creatorcontrib>Kaloshi, Gentian</creatorcontrib><creatorcontrib>Mokhtari, Karima</creatorcontrib><creatorcontrib>Taillibert, Sophie</creatorcontrib><creatorcontrib>Laigle-Donadey, Florence</creatorcontrib><creatorcontrib>Omuro, Antonio</creatorcontrib><creatorcontrib>Sanson, Marc</creatorcontrib><creatorcontrib>Delattre, Jean-Yves</creatorcontrib><creatorcontrib>Hoang-Xuan, Khê</creatorcontrib><title>Up-front temozolomide in elderly patients with anaplastic oligodendroglioma and oligoastrocytoma</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>Optimal treatment of anaplastic oligodendroglial tumors (AOT) in elderly patients is debatable. We report a retrospective study of 44 consecutive patients aged 70 years or older [median age: 74 years; median Karnofsky performance status (KPS): 70] treated with up-front chemotherapy using temozolomide (TMZ) at conventional doses until tumor progression. O
6
-methylguanine-DNA methyltransferase promoter (MGMTP) methylation was assessed in 38 patients. Of the 41 evaluable patients, partial response (PR) was seen in 13 (32%) patients, 17 (41%) patients achieved stable disease, while the disease progressed in 11 (27%) patients. Median progression-free survival (PFS) and overall survival (OS) were 6.9 and 12.4 months, respectively. Hematoxicity grades 3–4 occurred in nine patients (20%). MGMTP was methylated in 50% of patients and was associated with both longer PFS (8.7 versus 5.7 months,
P
= 0.01) and longer OS (16.1 versus 12.4 months,
P
= 0.05). The rate of responders to chemotherapy was similar in MGMTP-methylated (38%) and in MGMTP-unmethylated patients (31%), but duration of response was significantly longer in responders with methylated MGMTP than in responders with unmethylated MGMTP (16.1 versus 9.6 months,
P
= 0.0004). This study demonstrates that a substantial number of elderly patients with AOT can achieve prolonged survival with up-front chemotherapy using TMZ. Further investigation is needed to determine whether this treatment is preferable to initial radiation therapy.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Agents, Alkylating - pharmacology</subject><subject>Brain Neoplasms - drug therapy</subject><subject>Brain Neoplasms - genetics</subject><subject>Brain Neoplasms - pathology</subject><subject>Clinical Study – Patient Study</subject><subject>Dacarbazine - analogs & derivatives</subject><subject>Dacarbazine - pharmacology</subject><subject>DNA Methylation</subject><subject>DNA Modification Methylases - genetics</subject><subject>DNA Repair Enzymes - genetics</subject><subject>DNA, Neoplasm - genetics</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Oligodendroglioma - drug therapy</subject><subject>Oligodendroglioma - genetics</subject><subject>Oligodendroglioma - pathology</subject><subject>Oncology</subject><subject>Polymerase Chain Reaction</subject><subject>Promoter Regions, Genetic - genetics</subject><subject>Retrospective Studies</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>Tumor Suppressor Proteins - genetics</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kE1r3DAQhkVJaTbb_oBeguklJycj68s-lqVNAgu5JNCbqrWkrYJsuZKWsPvro-BtCoEchNDMM--IB6GvGC4xgLhKGAOHGnA5Daf14QNaYCZILYggJ2gBmIuadfTXKTpL6REAqCD4EzptgDFOW1ig3w9TbWMYc5XNEA7Bh8FpU7mxMl6b6PfVpLIzY07Vk8t_KjWqyauUXV8F77ZBm1HHsPUuDKo09VwtQAz9PpfiZ_TRKp_Ml-O9RA8_f9yvbur13fXt6vu67ik0uSa8sVz0zcY0ivSgbcuBlCdpqTK467DilquO9sK2nQZGlN1YTRrRcc05bskSXcy5Uwx_dyZlObjUG-_VaMIuyY5RDi3huJDf3pCPYRfH8jnZUtZhwRgrEJ6hPoaUorFyim5QcS8xyBf5cpYvi3z5Il8eysz5MXi3GYx-nfhnuwDNDKTSGrcm_t_8fuoz9zaRgQ</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>Ducray, François</creator><creator>Sierra del Rio, Monica</creator><creator>Carpentier, Catherine</creator><creator>Psimaras, Dimitri</creator><creator>Idbaih, Ahmed</creator><creator>Dehais, Caroline</creator><creator>Kaloshi, Gentian</creator><creator>Mokhtari, Karima</creator><creator>Taillibert, Sophie</creator><creator>Laigle-Donadey, Florence</creator><creator>Omuro, Antonio</creator><creator>Sanson, Marc</creator><creator>Delattre, Jean-Yves</creator><creator>Hoang-Xuan, Khê</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20110201</creationdate><title>Up-front temozolomide in elderly patients with anaplastic oligodendroglioma and oligoastrocytoma</title><author>Ducray, François ; Sierra del Rio, Monica ; Carpentier, Catherine ; Psimaras, Dimitri ; Idbaih, Ahmed ; Dehais, Caroline ; Kaloshi, Gentian ; Mokhtari, Karima ; Taillibert, Sophie ; Laigle-Donadey, Florence ; Omuro, Antonio ; Sanson, Marc ; Delattre, Jean-Yves ; Hoang-Xuan, Khê</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c402t-362f67c2be2a3c0df8603c2b384ae1991a6f6a94c7f89d053afbfd32796d66183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Agents, Alkylating - pharmacology</topic><topic>Brain Neoplasms - drug therapy</topic><topic>Brain Neoplasms - genetics</topic><topic>Brain Neoplasms - pathology</topic><topic>Clinical Study – Patient Study</topic><topic>Dacarbazine - analogs & derivatives</topic><topic>Dacarbazine - pharmacology</topic><topic>DNA Methylation</topic><topic>DNA Modification Methylases - genetics</topic><topic>DNA Repair Enzymes - genetics</topic><topic>DNA, Neoplasm - genetics</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurology</topic><topic>Oligodendroglioma - drug therapy</topic><topic>Oligodendroglioma - genetics</topic><topic>Oligodendroglioma - pathology</topic><topic>Oncology</topic><topic>Polymerase Chain Reaction</topic><topic>Promoter Regions, Genetic - genetics</topic><topic>Retrospective Studies</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>Tumor Suppressor Proteins - genetics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ducray, François</creatorcontrib><creatorcontrib>Sierra del Rio, Monica</creatorcontrib><creatorcontrib>Carpentier, Catherine</creatorcontrib><creatorcontrib>Psimaras, Dimitri</creatorcontrib><creatorcontrib>Idbaih, Ahmed</creatorcontrib><creatorcontrib>Dehais, Caroline</creatorcontrib><creatorcontrib>Kaloshi, Gentian</creatorcontrib><creatorcontrib>Mokhtari, Karima</creatorcontrib><creatorcontrib>Taillibert, Sophie</creatorcontrib><creatorcontrib>Laigle-Donadey, Florence</creatorcontrib><creatorcontrib>Omuro, Antonio</creatorcontrib><creatorcontrib>Sanson, Marc</creatorcontrib><creatorcontrib>Delattre, Jean-Yves</creatorcontrib><creatorcontrib>Hoang-Xuan, Khê</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Journal of neuro-oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ducray, François</au><au>Sierra del Rio, Monica</au><au>Carpentier, Catherine</au><au>Psimaras, Dimitri</au><au>Idbaih, Ahmed</au><au>Dehais, Caroline</au><au>Kaloshi, Gentian</au><au>Mokhtari, Karima</au><au>Taillibert, Sophie</au><au>Laigle-Donadey, Florence</au><au>Omuro, Antonio</au><au>Sanson, Marc</au><au>Delattre, Jean-Yves</au><au>Hoang-Xuan, Khê</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Up-front temozolomide in elderly patients with anaplastic oligodendroglioma and oligoastrocytoma</atitle><jtitle>Journal of neuro-oncology</jtitle><stitle>J Neurooncol</stitle><addtitle>J Neurooncol</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>101</volume><issue>3</issue><spage>457</spage><epage>462</epage><pages>457-462</pages><issn>0167-594X</issn><eissn>1573-7373</eissn><abstract>Optimal treatment of anaplastic oligodendroglial tumors (AOT) in elderly patients is debatable. We report a retrospective study of 44 consecutive patients aged 70 years or older [median age: 74 years; median Karnofsky performance status (KPS): 70] treated with up-front chemotherapy using temozolomide (TMZ) at conventional doses until tumor progression. O
6
-methylguanine-DNA methyltransferase promoter (MGMTP) methylation was assessed in 38 patients. Of the 41 evaluable patients, partial response (PR) was seen in 13 (32%) patients, 17 (41%) patients achieved stable disease, while the disease progressed in 11 (27%) patients. Median progression-free survival (PFS) and overall survival (OS) were 6.9 and 12.4 months, respectively. Hematoxicity grades 3–4 occurred in nine patients (20%). MGMTP was methylated in 50% of patients and was associated with both longer PFS (8.7 versus 5.7 months,
P
= 0.01) and longer OS (16.1 versus 12.4 months,
P
= 0.05). The rate of responders to chemotherapy was similar in MGMTP-methylated (38%) and in MGMTP-unmethylated patients (31%), but duration of response was significantly longer in responders with methylated MGMTP than in responders with unmethylated MGMTP (16.1 versus 9.6 months,
P
= 0.0004). This study demonstrates that a substantial number of elderly patients with AOT can achieve prolonged survival with up-front chemotherapy using TMZ. Further investigation is needed to determine whether this treatment is preferable to initial radiation therapy.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>20556480</pmid><doi>10.1007/s11060-010-0264-z</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of neuro-oncology, 2011-02, Vol.101 (3), p.457-462 |
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| language | eng |
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| subjects | Aged Aged, 80 and over Antineoplastic Agents, Alkylating - pharmacology Brain Neoplasms - drug therapy Brain Neoplasms - genetics Brain Neoplasms - pathology Clinical Study – Patient Study Dacarbazine - analogs & derivatives Dacarbazine - pharmacology DNA Methylation DNA Modification Methylases - genetics DNA Repair Enzymes - genetics DNA, Neoplasm - genetics Female Follow-Up Studies Humans Male Medicine Medicine & Public Health Neurology Oligodendroglioma - drug therapy Oligodendroglioma - genetics Oligodendroglioma - pathology Oncology Polymerase Chain Reaction Promoter Regions, Genetic - genetics Retrospective Studies Survival Rate Treatment Outcome Tumor Suppressor Proteins - genetics |
| title | Up-front temozolomide in elderly patients with anaplastic oligodendroglioma and oligoastrocytoma |
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