Temozolomide in High–Grade Gliomas: Rationale, Schedules and Synergism with Radiation

Stefano Dall’Oglio, Anna D’Amico, Fabio Pioli and Sergio Maluta (Editors)
University Hospital, Verona, Italy

Series: Cancer Etiology, Diagnosis and Treatments
BISAC: MED062000

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Volume 10

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Special issue: Resilience in breaking the cycle of children’s environmental health disparities
Edited by I Leslie Rubin, Robert J Geller, Abby Mutic, Benjamin A Gitterman, Nathan Mutic, Wayne Garfinkel, Claire D Coles, Kurt Martinuzzi, and Joav Merrick

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High-grade gliomas (HGG), glioblastoma multiforme (GBM) and anaplastic astrocytoma (AA) are still characterized by a dismal prognosis despite of recent advances in treatment options. Gold–standard therapy has involved maximum possible resection, followed by adjuvant irradiation plus TMZ followed by maintenance TMZ. TMZ has also proven its efficacy on tumors of oligodendroglial origin.

The conventional “5 out of 28 days” schedule of TMZ achieved an overall survival rate at 2 years of 26.5%; in patients with methylation of methylguanine methyltrasnsferase (MGMT) promoter, better results can be achieved but MGMT methylation status determination is feasible only in few centres. Dose–intensity TMZ schedules have the capability of depleting MGMT in tumor cells, thus promising a better outcome also in non – methylated patients. This new book discusses a possible rationale for intensified regimens of TMZ administration and reviews its possible benefits and risks, with a focus on results of clinical trials and reported toxicity cases. (Imprint: Nova Biomedical)

Abstract

Introduction: Rationale for Temozolomide in High–Grade Gliomas

The Current Use of Temozolomide in High–Grade Gliomas

MGMT: Mechanisms of Action

The Standard Use of TMZ

Temozolomide and Radiotherapy

New Radiotherapy Techniques in the Treatment Strategy of HGG

TMZ Concomitant with Radiation: Is There a Rationale for That?

Comparison of the Standard Temozolomide Schedule with the Alternative Ones

Anaplastic (Grade - III) Gliomas

Temozolomide – Related Toxicity

Conclusion

References

Index

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