Temozolomide Not Effective for Brain Metastases from Breast Cancer

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According to a new study published in the journal Annals of Oncology, whole-brain radiotherapy plus temozolomide does not improve local control, progression-free survival, or overall survival in patients with brain metastases from breast cancer.

For the multicenter, prospective, phase 2 study, researchers sought to investigate the safety and efficacy of whole-brain radiation therapy plus temozolomide for the treatment of patients with brain metastases from breast cancer.

They enrolled 100 patients with newly diagnosed intraparenchymal brain metastases from breast cancer who were not candidates for surgery or radiosurgery. Participants were randomly assigned to receive whole-brain radiation therapy with or without temozolomide. Patients were followed for a median of 9.4 months.

At 6 weeks, patients in combination arm achieved an objective response rate of 30% compared with 36% in the whole-brain radiation therapy alone group. Median progression-free survival for the combination group and radiation alone group were 6.9 months and 7.4 months, respectively. Median overall survival for those receiving radiation therapy plus temozolomide was 9.4 months versus 11.1 months among those receiving radiation alone.

Both treatments were well tolerated. The findings suggest that the addition of temozolomide to whole-brain radiation therapy for the treatment of brain metastases from breast cancer is not more effective that whole-brain radiation therapy alone.

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Radiotherapy + temozolomide does not improve survival in patients with brain metastases from breast cancer.
The authors investigated the efficacy and safety of WBRT combined with temozolomide (TMZ) in this population, to improve the therapeutic index of whole–brain radiation therapy (WBRT) in the treatment of brain metastases from breast cancer. Whole–brain radiation therapy combined with temozolomide did not significantly improve local control and survival in patients with brain metastases from breast cancer.

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