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Older people with glioblastoma lived as long on temozolomide tablets as on radiotherapy, and the MGMT test showed who should get which: methylated tumours did better with the chemotherapy and unmethylated tumours with radiotherapy.
Randomised phase 3 non-inferiority trial of the German Neuro-oncology Working Group in 412 patients over 65 with anaplastic astrocytoma or glioblastoma, comparing dose-dense temozolomide (one week on, one week off) with radiotherapy of 60 Gy; 373 patients were treated and analysed.
Median overall survival was 8.6 months with temozolomide against 9.6 months with radiotherapy (hazard ratio 1.09), meeting non-inferiority, and event-free survival did not differ. MGMT promoter methylation was associated with longer survival and predicted benefit from temozolomide (event-free survival 8.4 against 4.6 months), while unmethylated tumours did better with radiotherapy (3.3 against 4.6 months).
With the Nordic trial, NOA-08 made MGMT testing the way to choose between temozolomide alone and radiotherapy alone for older patients with glioblastoma who are not offered combined treatment.
Shares Temozolomide, Glioma & glioblastoma.
Shares Temozolomide, Glioma & glioblastoma.
Shares Temozolomide, Glioma & glioblastoma.
Shares Temozolomide, Glioma & glioblastoma.
Shares Temozolomide, Glioma & glioblastoma.
Shares Temozolomide, Glioma & glioblastoma.
Shares Temozolomide, Glioma & glioblastoma.
Shares Temozolomide, Glioma & glioblastoma.