TMZ
| Property | Information |
|---|---|
| Drug Name | Temozolomide (TMZ) |
| Overview | Temozolomide is an oral alkylating chemotherapy agent commonly used as a standard treatment for glioblastoma. It works by damaging the DNA of cancer cells, thereby inhibiting their ability to replicate and leading to cell death. |
| FDA Approval | Yes, FDA-approved for glioblastoma and anaplastic astrocytoma |
| Used for | Standard treatment for glioblastoma, often in combination with radiotherapy and as maintenance therapy |
| Clinical Trial Phase | Approved; ongoing research into optimizing its use and combining it with other therapies |
| Clinical Trial Explanation | Not specified |
| Common Side Effects | Nausea, vomiting, fatigue, loss of appetite, myelosuppression (reduced blood cell counts), and an increased risk of infections |
| OS without | 12.1 months (median overall survival with radiotherapy alone) |
| OS with | 14.6 months (median overall survival with concurrent radiotherapy and TMZ) |
| PFS without | 5.0 months (median progression-free survival with radiotherapy alone) |
| PFS with | 6.9 months (median progression-free survival with concurrent radiotherapy and TMZ) |
| Usefulness Rating | 5 |
| Usefulness Explanation | Not specified |
| Toxicity Level | 3 |
| Toxicity Explanation | Temozolomide has a moderate toxicity level, primarily related to its effects on bone marrow, which can lead to reduced blood cell counts. This increases the risk of infections, anemia, and bleeding. Careful monitoring is required during treatment to manage side effects and adjust doses as needed. |
Notes: Temozolomide (TMZ) is the backbone of glioblastoma treatment and has significantly improved survival outcomes when combined with radiotherapy. Its efficacy is influenced by the MGMT (O6-methylguanine-DNA methyltransferase) promoter methylation status of the tumor. Patients with methylated MGMT have better responses to TMZ due to reduced tumor DNA repair capacity.
Temozolomide and MGMT Methylation
Studies have shown that patients with MGMT promoter methylation derive greater benefit from TMZ, with improved overall and progression-free survival compared to those without methylation. MGMT methylation testing is often used to guide treatment decisions. See https://glioblastomatreatments.wiki/index.php?title=Main_Page#The_Role_of_MGMT <ref>Template:Cite web</ref>
Optimization and Combination Strategies
Ongoing research aims to optimize TMZ dosing schedules and combine it with other therapies, such as immune checkpoint inhibitors, targeted therapies, and experimental agents, to further improve outcomes. Studies on alternating metronomic doses of TMZ are also being explored to minimize toxicity while maintaining efficacy.<ref>Template:Cite web</ref>
Future clinical trials are investigating how TMZ can be integrated with emerging therapies and biomarkers to better tailor treatments to individual patient profiles.<ref>Template:Cite web</ref>
From Ben Williams Book: Not specified
