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Cancer Resources > Cancer News > Cancer News from Reuters > Reuters Cancer News > 2006 > March
Prolonged lymphopenia common with long-term temozolomide for glioma
Last Updated: 2006-03-09 14:33:35 -0400 (Reuters Health)
NEW YORK (Reuters Health) - In patients with glioma, long-term temozolomide therapy is commonly associated with prolonged, cumulative lymphopenia and a high incidence of infections, according to a report in the February 14 issue of Neurology.
"Compared with standard temozolomide, temozolomide 3 weeks on/1 week off schedule incurs an increased risk of cumulative lymphopenia and exposes patients to opportunistic infections," Dr. Alicia Tosoni from the University Hospital of Padua, Italy told Reuters Health.
Dr. Tosoni and colleagues investigated the safety of 75 mg/m² temozolomide for 21 days every 28 days in 51 patients with glioma.
Overall, lymphopenia occurred in 52.9% of the patients, the authors report. Lymphopenia appear to be cumulative, as the rate increased from 25% in patients receiving no more than three cycles to 91% in patients receiving 10 or more cycles of chemotherapy.
About 12% of the patients developed grade 1 or 2 infections, the results indicate.
Chemotherapy was discontinued in 27 patients because of disease progression and in six patients because of adverse events that did not resolve within 3 weeks, the researchers note.
Although treatment response was not an endpoint of the current study, two of five patients with anaplastic glioma and one of nine patients with low-grade glioma experienced at least a partial response, according to the report. The remaining three patients with anaplastic glioma, five of nine patients with glioblastoma, and seven patients with low-grade glioma had disease stabilization.
"Several schedules, consisting of the protracted daily administration of temozolomide, have been explored in phase I/II clinical trials with the aim of overcoming chemoresistance through AGAT depletion," Dr. Tosoni explained. "Notwithstanding the theoretical interest of this hypothesis, as yet it has not been demonstrated that continuous schedules offer any significant increase in antitumoral activity."
"Furthermore," Dr. Tosoni said, "our study demonstrated that temozolomide 3 weeks on/1 week off schedule incurs an increased risk of prolonged lymphopenia. Therefore, this protracted temozolomide schedule should be used in clinical practice only if proven to be more effective than standard schedule."
Therefore, Dr. Tosoni concluded, "further randomized trials are required to define the activity of protracted schedules of temozolomide administration, with the aim of studying how to overcome drug resistance and improve the prognosis of patients with glioma."
Neurology 2006;66:427-429.
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