No Difference in PFS Between RT and Temozolomide in Glioma

Patients with low-grade glioma have no significant difference in progression-free survival when treated with either radiotherapy alone or temozolomide chemotherapy alone, according to a study published in The Lancet Oncology.¹

Researchers in the Netherlands conducted a randomized, open-label, phase 3 intergroup study of 477 patients to compare progression-free survival outcomes from the 2 single-modality treatment options.

Treatment allocation was randomly conducted online through a minimization technique with prospective stratification across 78 clinical centers by 1p deletion, contrast enhancement, age, and WHO performance status. Planned analysis was performed after 216 progression events.

Median follow-up was 48 months. Median progression-free survival was 39 months for patients treated with temozolomide, and 46 months for those treated with radiotherapy.

Three recently defined molecular low-grade glioma subgroups–IDHmt, with or without 1p/19q co-deletion, or IDH wild type–were confirmed upon exploratory analyses in 318 molecularly-defined patients. Patients with IDHmt/non-codel tumors who were treated with radiotherapy had longer progression-free survival than patients treated with temozolomide.

Thirty-two of the 236 patients treated with temozolomide experienced grade 3 to 4 hematological adverse events, in contrast with 1 of 228 patients treated with radiotherapy. Eight of the patients treated with temozolomide experienced grade 3 to 4 infections, in contrast with 2 treated with radiotherapy.

Reference

1. Baumert BG, Hegi ME, van den Bent MJ, et al. Temozolomide chemotherapy versus radiotherapy in high-risk low-grade glioma (EORTC 22033-26033): a randomised, open-label, phase 3 intergroup study. The Lancet Oncol. 2016 Sep 27. doi: 10.1016/S1470-2045(16)30313-8 [Epub ahead of print]