Table 3.
Types of low-grade glioma, prior therapy, toxicity, response, and final outcome in 30 patients with recurrent low-grade glioma treated with oral temozolomide
| Pt. No. | Age (Years)/ Sex | Diagnosis | Prior Therapy | No. of Cycles of TMZ | Best Response | Overall Response | Worst Toxicity Due to TMZ | Disease Course After Coming Off Study and Salvage Therapy | Final Outcome/ Duration of Survival |
|---|---|---|---|---|---|---|---|---|---|
| 1 | 7/M | OPG | PCV | 11 | SD | PD | Grade 2 rash | Oral VP-16 | SD/77+ months |
| 2 | 10/M | OPG | Carboplatin | 12 | SD | SD | None | PD, vinblastine, XRT | SD/53 months |
| 3 | 13/M | OPG/NF-1 | Carboplatin | 12 | SD | SD | Grade 4 plts | Stable | SD/42 months |
| 4 | 9/F | OPG/NF-1 | None | 5 | SD | PD | None | Carboplatin | SD/38 months |
| 5 | 13/F | OPG/NF-1 | None | 10 | PR | PD* | None | XRT, carboplatin | SD/24 months |
| 6 | 9/M | OPG | Surgery, carboplatin + VCR, TPCV, oral VP-16 | 9 | SD | PD | Grade 4 plts | Surgery, XRT | Dead/38 months** |
| 7 | 5/M | OPG | TPCV, carboplatin + RMP-7 | 6 | SD | PD | Grade 4 plts | NA | SD/41 months |
| 8 | 13/F | OPG | Surgery, TPCV, carboplatin + VCR, XRT | 3 | SD | PD | None | None | Dead/3 months |
| 9 | 5/M | OPG | Carboplatin + VCR | 12 | SD | SD | None | Stable | SD/41 months |
| 10 | 16/M | OPG | Carboplatin + VCR | 12 | SD | SD | Grade 1 fatigue | PD, XRT | SD/47 months |
| 11 | 5/F | OPG/NF-1 | Carboplatin + VCR | 9 | SD | PD | Grade 1 ANC | TPCV | SD/28 months |
| 12 | 8/M | OPG | Carboplatin + VCR | 12 | SD | SD | Grade 1 ANC | PD, vinblastine | SD/27 months |
| 13 | 12/M | OPG | Carboplatin + VCR | 9† | SD | SD | Grade 2 Plts | Stable | SD/20 months |
| 14 | 4/M | OPG | Carboplatin + VCR | 4‡ | SD | SD | Grade 4 ANC | Stable, TPCV | SD/21 months |
| 15 | 17/F | PA (tectal) | Carboplatin | 8 | PR | PR | Grade 3 hemorrhage into tumor | PD, carboplatin, XRT, vinblastine | SD/62+ months |
| 16 | 16/M | PA (cerebral) | Surgery | 9 | SD | PD | Grade 3 ANC | Surgery, XRT, CPT-11 | NED/48 months |
| 17 | 17/F | PA (hypothalamic) | Surgery | 12 | PR | PR | Grade 2 plts | Stable | SD/45 months |
| 18 | 11/F | PA (hypothalamic) | Surgery | 12 | SD | SD | None | Stable | SD/41 months |
| 19 | 16/M | PA (hypothalamic) | Surgery | 12 | MR | MR | Grade 2 ANC | Stable | SD/36 months |
| 20 | 10/F | PA (hypothalamic) | Surgery | 12 | SD | PD | Grade 2 plts | Carboplatin, TPCV | PD/38 months |
| 21 | 11/F | PA (thalamic) | Surgery | 6 | SD | PD | Grade 4 plts | Carboplatin, CPT-11 | Dead/26 months |
| 22 | 9/M | PA (hypothalamic) | Surgery | 6 | SD | PD | None | Carboplatin | SD/30 months |
| 23 | 14/M | PA (brainstem) | Carboplatin | 5 | SD | PD | None | Surgery | SD/9 months |
| 24 | 6/M | PA (brainstem) | Surgery, TPCV | 12 | SD | SD | None | Stable | SD/34 months |
| 25 | 5/M | PA | Surgery, carboplatin, TPCV | 12 | SD | SD | Grade 2 ANC | Stable | SD/33 months |
| 26 | 14/M | PA | Carboplatin + VCR, XRT | 12 | SD | SD | Grade 1 ANC | Stable | SD/40 months |
| 27 | 12/M | FA (cerebral) | Surgery | 12 | SD | PD | Grade 4 plts, ANC | Carboplatin, XRT | SD/35 months |
| 28 | 10/M | FA | Surgery | 2 | PD | PD | Grade 1 anemia | Carboplatin + VCR, XRT | SD/41 months |
| 29 | 10/M | FA | TPCV, estramustine + VP-16, XRT | 12 | SD | SD | Grade 1 fatigue, ANC | PD, carboplatin + VCR | SD/39 months |
| 30 | 10/M | FA | Carboplatin + VCR | 7 | SD | PD | None | XRT | SD/16 months |
Abbreviations: ANC, absolute neutrophil count; CPT-11, irinotecan; FA, fibrillary astrocytoma; MR, minimal response; NA, not available; NED, no evidence of disease; NF-1, neurofibromatosis type 1; OPG, optic pathway glioma; PA, pilocytic astrocytoma; PCV, procarbazine; PD, progressive disease; plts, platelets; PR, partial response; RMP-7, labridimil; SD, stable disease; TMZ, temozolomide; TPCV, thioguanine, procarbazine, chloroethyl cyclohexylnitrosourea (lomustine), and vincristine; VCR, vincristine; VP-16, etoposide; XRT, focal radiotherapy.
Patient had progressive disease based on change in visual acuity but MRI revealed stable disease.
Patient found on second biopsy to have elements of atypical teratoid/rhabdoid tumor.
Patient taken off study due to diagnosis of Lyme disease.
Patient taken off study due to prolonged neutropenia and started on TPCV chemotherapy eight months later.