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Temozolomide in children with progressive low-grade glioma

Sridharan Gururangan1, Michael J Fisher, Jeffrey C Allen

  • 1Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Box 3624, Durham, NC 27710, USA. gurur002@mc.duke.edu

Neuro-Oncology
|March 10, 2007
PubMed

Insights

Oral temozolomide (TMZ) stabilized disease in over half of pediatric patients with optic pathway glioma (OPG)/pilocytic astrocytoma (PA). This treatment showed manageable toxicity, offering a potential option for progressive low-grade glioma.

Area of Science:

  • Pediatric Oncology
  • Neuro-Oncology
  • Clinical Pharmacology

Background:

  • Low-grade gliomas are the most common brain tumors in children.
  • Optic pathway gliomas (OPGs) and pilocytic astrocytomas (PAs) represent a significant subset of pediatric low-grade gliomas.
  • Progressive disease necessitates effective and tolerable treatment options.

Purpose of the Study:

  • To evaluate the efficacy of oral temozolomide (TMZ) in children with progressive low-grade glioma.
  • To assess response rates, disease stabilization, and survival outcomes.
  • To determine the toxicity profile of TMZ in this pediatric population.

Main Methods:

  • Phase II clinical trial design.
  • Enrollment of 30 eligible pediatric patients with progressive low-grade glioma.
  • Administration of oral temozolomide (200 mg/m(2)/day for 5 days every 4 weeks) for a median of 9 cycles.

Main Results:

  • Among 26 patients with OPG/PA, 54% achieved disease stabilization, with a median disease control of 34 months.
  • Two-year progression-free survival was 49% and overall survival was 96% in OPG/PA patients.
  • Common toxicities included grade 2-4 thrombocytopenia and neutropenia in 7 patients each.

Conclusions:

  • Oral temozolomide demonstrated efficacy in stabilizing disease in a significant proportion of pediatric patients with OPG/PA.
  • The observed toxicity profile was manageable, suggesting TMZ as a viable treatment option.
  • Further investigation into TMZ's role in pediatric low-grade gliomas is warranted.

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