Rare Brain Cancer Outcomes Improve with Radiation Therapy and Temozolomide

A European phase 3 clinical trial showed positive results from adjuvant chemotherapy in patients with anaplastic glioma without 1p and 19 co-deletion.

The study’s findings were presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting.

The Concurrent and Adjuvant Temozolomide Chemotherapy in Non-1p/19q Deleted Anaplastic Glioma (CATNON) trial enrolled 748 randomized patients who lacked 1p/19q co-deletion to receive radiation therapy alone; temozolomide during radiation therapy; temozolomide during and after radiation therapy; and temozolomide after radiation therapy (adjuvant temozolomide).

The results of the study found that participants administered temozolomide after radiation, with or without concurrent temozolomide saw a slower progression of the disease compared with patients treated without adjuvant therapy.

Furthermore, the median time to disease progression was more than double in the adjuvant temozolomide arm, at 42.8 months versus 19 months, respectively. Patients treated with adjuvant temozolomide did not reach a median overall survival.

The 5-year survival rate was 56% in patients who received adjuvant temozolomide versus 44% in patients who received radiation therapy alone or with temozolomide administered during the radiation.

“Until this study, doctors had no evidence to support the use of adjuvant temozolomide in patients with grade 3 anaplastic glioma,” said lead study author Martin J. van den Bent, MD. “These findings should expand treatment choices and change the way we treat patients with this rare form of brain cancer.”

The most common toxicities for patients in the temozolomide study arms were hematology and severe toxicity, experienced in 5 to 10% of patients. Final data from patients given temozolomide during radiation therapy only is currently unavailable and is expected to be released in 2020.

Future studies will reassess additional genetic abnormalities that are known to affect cancer prognoses such as MGMT promotor methylation and IDH mutation.