Department of Neurology, University of Michigan, 1500 E. Medical Center Dr., 1914 Taubman Center, Ann Arbor, MI, 48109, USA.
Curr Oncol Rep. 2019 Mar 5;21(4):30. doi: 10.1007/s11912-019-0783-5.
Temozolomide is a first-line treatment for newly diagnosed glioblastoma. In this review, we will examine the use of temozolomide in other contexts for treating gliomas, including recurrent glioblastoma, glioblastoma in the elderly, diffuse low- and high-grade gliomas, non-diffuse gliomas, diffuse intrinsic pontine glioma (DIPG), ependymoma, pilocytic astrocytoma, and pleomorphic xanthoastrocytoma.
Temozolomide improved survival in older patients with glioblastoma, anaplastic gliomas regardless of 1p/19q deletion status, and progressive ependymomas. Temozolomide afforded less toxicity and comparable efficacy to radiation in high-risk low-grade gliomas and to platinum-based chemotherapy in pediatric high-grade gliomas. The success of temozolomide in promoting survival has expanded beyond glioblastoma to benefit patients with non-glioblastoma tumors. Identifying practical biomarkers for predicting temozolomide susceptibility, and establishing complementary agents for chemosensitizing tumors to temozolomide, will be key next steps for future success.
替莫唑胺是新诊断胶质母细胞瘤的一线治疗药物。在这篇综述中，我们将研究替莫唑胺在治疗其他类型胶质瘤中的应用，包括复发性胶质母细胞瘤、老年胶质母细胞瘤、弥漫性低级别和高级别胶质瘤、非弥漫性胶质瘤、弥漫性内在脑桥胶质瘤（DIPG）、室管膜瘤、毛细胞型星形细胞瘤和多形性黄色星形细胞瘤。
替莫唑胺改善了老年胶质母细胞瘤、无论 1p/19q 缺失状态如何的间变性神经胶质瘤以及进行性室管膜瘤患者的生存。替莫唑胺在高危低级别胶质瘤中与放疗、在儿科高级别胶质瘤中与铂类化疗相比，毒性更小，疗效相当。替莫唑胺在促进生存方面的成功已经超出了胶质母细胞瘤的范围，使非胶质母细胞瘤肿瘤患者受益。确定预测替莫唑胺敏感性的实用生物标志物，并为替莫唑胺增敏肿瘤建立互补药物，将是未来成功的关键下一步。
