Extended adjuvant temozolomide >6 months tied to better survival in glioblastoma

More than 6 cycles of extended adjuvant temozolomide (TMZ) therapy may result in better overall (OS) and progression-free survival (PFS) in patients with glioblastoma multiform, suggests a study.

A group of researchers reviewed the medical records of 329 patients diagnosed with diffuse gliomas in two cancer centres in Egypt from January 2008 to December 2018. They collected data on patient demographics, presenting complaints, tumour size, adverse events, and treatment modalities (ie, extent of surgery, radiotherapy dose and technique, concomitant TMZ, and number of adjuvant TMZ cycles).

Of the 105 patients treated with adjuvant TMZ, 33 received <6 cycles (TMZL), 41 received the standard 6 cycles (TMZS), and 31 received >6 cycles (TMZE).

The TMZE arm showed the highest median OS at 27.33 months compared with 15.83 months in the TMZS arm and just 8.47 months in the TMZL arm (p<0.001). Likewise, median PFS was highest in the TMZE arm at 22.90 months compared with 12.7 months and 6.35 months in the TMZS and TMZL arms, respectively (p<0.001).

Multivariate analysis revealed that the extended adjuvant TMZ with a hazard ratio of 3.106 (95 percent confidence interval, 2.43‒14.46; p<0.001) significantly correlated with a better outcome.

“Extended adjuvant TMZ therapy beyond 6 cycles may significantly improve the PFS and OS in patients with glioblastoma multiform,” the researchers said.