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Concurrent and Adjuvant Temozolomide for Newly Diagnosed Grade III Gliomas Without 1p/19q Co-deletion: A Randomized, Open-Label, Phase 2 Study (KNOG-1101 Study)

Authors
 Kihwan Hwang  ;  Tae Min Kim  ;  Chul-Kee Park  ;  Jong Hee Chang  ;  Tae-Young Jung  ;  Jin Hee Kim  ;  Do-Hyun Nam  ;  Se-Hyuk Kim  ;  Heon Yoo  ;  Yong-Kil Hong  ;  Eun-Young Kim  ;  Dong-Eun Lee  ;  Jungnam Joo  ;  Yu Jung Kim  ;  Gheeyoung Choe  ;  Byung Se Choi  ;  Seok-Gu Kang  ;  Jeong Hoon Kim  ;  Chae-Yong Kim 
Citation
 CANCER RESEARCH AND TREATMENT, Vol.52(2) : 505-515, 2020-04 
Journal Title
 CANCER RESEARCH AND TREATMENT 
ISSN
 1598-2998 
Issue Date
2020-04
Keywords
1p/19q co-deletion ; Adjuvant treatment ; Anaplastic glioma ; Chemotherapy ; Temozolomide
Abstract
Purpose: We investigated the efficacy of temozolomide during and after radiotherapy in Korean adults with anaplastic gliomas without 1p/19q co-deletion. Materials and methods: This was a randomized, open-label, phase 2 study and notably the first multicenter trial for Korean grade III glioma patients. Eligible patients were aged 18 years or older and had newly diagnosed non-co-deleted anaplastic glioma with an Eastern Cooperative Oncology Group performance status of 0-2. Patients were randomized 1:1 to receive radiotherapy alone (60 Gy in 30 fractions of 2 Gy) (control group, n=44) or to receive radiotherapy with concurrent temozolomide (75 mg/m2/day) followed by adjuvant temozolomide (150-200 mg/m2/day for 5 days during six 28-day cycles) (treatment group, n=40). The primary end-point was 2-year progression-free survival (PFS). Seventy patients (83.3%) were available for the analysis of the isocitrate dehydrogenase 1 gene (IDH1) mutation status. Results: The two-year PFS was 42.2% in the treatment group and 37.2% in the control group. Overall survival (OS) did not reach to significant difference between the groups. In multivariable analysis, age was a significant risk factor for PFS (hazard ratio [HR], 2.08; 95% confidence interval [CI], 1.04 to 4.16). The IDH1 mutation was the only significant prognostic factor for PFS (HR, 0.28; 95% CI, 0.13 to 0.59) and OS (HR, 0.19; 95% CI, 0.07 to 0.50). Adverse events over grade 3 were seen in 16 patients (40.0%) in the treatment group and were reversible. Conclusion: Concurrent and adjuvant temozolomide in Korean adults with newly diagnosed non-co- deleted anaplastic gliomas showed improved 2-year PFS. The survival benefit of this regimen needs further analysis with long-term follow-up at least more than 10 years.
Files in This Item:
T202001295.pdf Download
DOI
10.4143/crt.2019.421
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Gu(강석구) ORCID logo https://orcid.org/0000-0001-5676-2037
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/176080
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