Temozolomide based treatment in glioblastoma: 6 vs. 12 months

Fasano,Morena; Pirozzi,Mario; De Falco,Vincenzo; Miceli,Chiara Carmen; Farese,Stefano; Zotta,Alessia; Famiglietti,Vincenzo; Vitale,Pasquale; Giovanni,Ilaria Di; Brancati,Christian; Carfora,Vincenzo; Solari,Domenico; Somma,Teresa; Cavallo,Luigi Maria; Cappabianca,Paolo; Conson,Manuel; Pacelli,Roberto; Ciardiello,Fortunato; Addeo,Raffaele

doi:10.3892/ol.2024.14551

Temozolomide based treatment in glioblastoma: 6 vs. 12 months

Authors:
- Morena Fasano
- Mario Pirozzi
- Vincenzo De Falco
- Chiara Carmen Miceli
- Stefano Farese
- Alessia Zotta
- Vincenzo Famiglietti
- Pasquale Vitale
- Ilaria Di Giovanni
- Christian Brancati
- Vincenzo Carfora
- Domenico Solari
- Teresa Somma
- Luigi Maria Cavallo
- Paolo Cappabianca
- Manuel Conson
- Roberto Pacelli
- Fortunato Ciardiello
- Raffaele Addeo
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Affiliations: Medical Oncology Unit, Department of Precision Medicine, University of Campania Luigi Vanvitelli, I‑80131 Naples, Italy, Oncology Unit, ‘San Giovanni di Dio’ Hospital, ASL Napoli 2 Nord, I‑80020 Frattamaggiore, Italy, Radiation Oncology Unit, Department of Radiation Oncology, ‘San Pio’ Hospital, I‑82100 Benevento, Italy, Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, I‑80131 Naples, Italy, Department of Advanced Biomedical Sciences, University of Naples Federico II, I‑80131 Naples, Italy
Published online on: July 2, 2024 https://doi.org/10.3892/ol.2024.14551
Article Number: 418
Copyright: © Fasano et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The Stupp regimen remains the standard treatment for newly diagnosed glioblastomas, although the prognosis remains poor. Several temozolomide alternative schedules have been studied, with extended adjuvant treatment (>6 cycles of temozolomide) frequently used, although different trials have indicated contrasting results. Survival data of 87 patients who received 6 (‘6C’ group) or 12 (‘12C’ group) cycles of temozolomide were collected between 2012 and 2022. A total of 45 patients were included in the 6C group and 42 patients were included in the 12C group. Data on isocitrate dehydrogenase mutation and methylguanine‑DNA‑methyltransferase (MGMT) promoter methylation status were also collected. The 12C group exhibited statistically significantly improved overall survival [OS; 22.8 vs. 17.5 months; hazard ratio (HR), 0.47; 95% CI, 0.30‑0.73; P=0.001] and progression‑free survival (15.3 vs. 9 months; HR, 0.39; 95% CI, 0.25‑0.62; P=0.001). However, in the subgroup analysis according to MGMT status, OS in the 12C group was significantly superior to OS in the 6C group only in the MGMT unmethylated tumors. The present data suggested that extended adjuvant temozolomide appeared to be more effective than the conventional six cycles.

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