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. 2024 Jul 2;28(3):418.
doi: 10.3892/ol.2024.14551. eCollection 2024 Sep.

Temozolomide based treatment in glioblastoma: 6 vs. 12 months

Morena Fasano  1 , Mario Pirozzi  1 , Vincenzo De Falco  2 , Chiara Carmen Miceli  1 , Stefano Farese  1 , Alessia Zotta  1 , Vincenzo Famiglietti  1 , Pasquale Vitale  2 , Ilaria Di Giovanni  2 , Christian Brancati  2 , Vincenzo Carfora  3 , Domenico Solari  4 , Teresa Somma  4 , Luigi Maria Cavallo  4 , Paolo Cappabianca  4 , Manuel Conson  5 , Roberto Pacelli  5 , Fortunato Ciardiello  1 , Raffaele Addeo  2
Affiliations

Temozolomide based treatment in glioblastoma: 6 vs. 12 months

Morena Fasano et al. Oncol Lett. .

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.

Keywords: Stupp; adjuvant therapy; extended temozolomide; glioblastoma.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1.
Figure 1.
Median (A) OS and (B) PFS in the 6 and 12 cycles groups. HR, hazard ratio; OS, overall survival; PFS, progression-free survival.
Figure 2.
Figure 2.
Median (A) OS and (B) PFS in O6-methylguanine-DNA-methyltransferase-methylated patients in the 6 and 12 cycles groups. HR, hazard ratio; OS, overall survival; PFS, progression-free survival.
Figure 3.
Figure 3.
Median (A) OS and (B) PFS in O6-methylguanine-DNA-methyltransferase-unmethylated patients in the 6 and 12 cycles groups. HR, hazard ratio; OS, overall survival; PFS, progression-free survival.
Figure 4.
Figure 4.
Median (A) OS and (B) PFS in isocitrate dehydrogenase wild-type patients in the 6 and 12 cycles groups. HR, hazard ratio; OS, overall survival; PFS, progression-free survival.
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