Temozolomide as salvage treatment in primary brain lymphomas

• Published in: British journal of cancer 2007-03, Vol.96 (6), p.864-867
• Main Authors: Reni, M, Zaja, F, Mason, W, Perry, J, Mazza, E, Spina, M, Bordonaro, R, Ilariucci, F, Faedi, M, Corazzelli, G, Manno, P, Franceschi, E, Pace, A, Candela, M, Abbadessa, A, Stelitano, C, Latte, G, Ferreri, A J M
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Agents, Alkylating - administration & dosage; Antineoplastic Agents, Alkylating - adverse effects; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Brain Neoplasms - drug therapy; Cancer Research; Clinical Study; Dacarbazine - administration & dosage; Dacarbazine - adverse effects; Dacarbazine - analogs & derivatives; Drug Resistance; Epidemiology; Female; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma - drug therapy; Male; Medical sciences; Middle Aged; Molecular Medicine; Neoplasm Recurrence, Local - drug therapy; Oncology; Salvage Therapy; Temozolomide; Tumors
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/sj.bjc.6603660

Methotrexate (MTX)-based chemotherapy extends survival in patients with primary brain lymphomas, but it is not clear whether multiagent chemotherapy is superior to MTX alone. Treatment options for patients with recurrent primary brain lymphoma are limited; there is no standard second-line chemotherapy. New chemotherapeutic agents with clear activity in brain lymphoma are needed for treatment of recurrent disease. We report the results of a phase II trial assessing activity of the alkylating agent temozolomide in immunocompetent patients with recurrent primary brain lymphomas, previously treated with high-dose MTX-containing chemotherapy and/or radiotherapy. A median of two courses (range 1–12) of temozolomide 150 mg m −2  day −1 , for 5 days every 4 weeks was administered to 36 patients yielding nine complete and two partial responses (response rate: 31%; 95% confidence interval 16–46%). One-year survival was 31% (95% confidence interval 16–46%). Toxicity was negligible. We conclude that temozolomide is active in recurrent primary brain lymphomas and should further be evaluated in this disease, perhaps in combination with MTX as initial treatment.