Journal of Neuro-Oncology

, Volume 123, Issue 1, pp 129–134 | Cite as

Radiotherapy and temozolomide for anaplastic astrocytic gliomas

  • Lakshmi Nayak
  • Katherine S. Panageas
  • Anne S. Reiner
  • Jason T. Huse
  • Elena Pentsova
  • Stephanie G. Braunthal
  • Lauren E. Abrey
  • Lisa M. DeAngelis
  • Andrew B. Lassman
Clinical Study


We previously reported results of a phase II non-comparative trial that randomized patients with glioblastoma following radiotherapy to one of two different temozolomide schedules, followed by 13-cis-retinoic acid (RA) maintenance. Here we report the results of an exploratory cohort of patients accrued with anaplastic astrocytic tumors. Patients with newly diagnosed anaplastic astrocytoma (AA) or anaplastic oligo-astrocytoma (AOA) were treated with concurrent radiotherapy (60 Gy over 6 weeks) and temozolomide (75 mg/m2), and six adjuvant 28-day cycles of either dose-dense (150 mg/m2, days 1–7, 15–21) or metronomic (50 mg/m2, days 1–28) temozolomide. Subsequently, maintenance RA (100 mg/m2, days 1–21/28) was administered until disease progression. All outcome measures were descriptive without intention to compare between treatment arms. Survival was measured by the Kaplan–Meier method. There were 31 patients (21 men, 10 women) with median age 48 years (range 28–74), median KPS 90 (range 60–100). Extent of resection was gross-total in 35 %, subtotal 23 %, and biopsy 42 %. Histology was AA in 90 %, and AOA in 10 %. MGMT promoter methylation was methylated in 20 %, unmethylated in 50 %, and uninformative in 30 % of 30 tested. Median progression-free survival was 2.1 years (95 % CI 0.95–Not Reached), and overall survival 2.9 years (95 % CI 2.0–Not Reached). We report outcomes among a homogeneously treated population with anaplastic astrocytic tumors. Survival was unexpectedly short compared to other reports. These data may be useful as a contemporary historic control for other ongoing or future randomized trials.


Anaplastic astrocytoma Temozolomide Radiotherapy Chemotherapy Clinical trial 



Financial support was received from Merck (formerly Schering Plough) for MGMT analyses and for partial study costs. K.S.P. and A.S.R. were supported in part by P30 CA008748.

Conflict of interest

ABL previously received honoraria from Merck/Schering-Plough for speaking and consulting. LEA is currently a full time employee of F-Hoffman-La Roche Ltd. LN, KSP, ASR, JTH, EP, SGB, and LMD have no relevant disclosures.

Supplementary material

11060_2015_1771_MOESM1_ESM.tif (433 kb)
Supplementary material 1 (TIFF 433 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Lakshmi Nayak
    • 1
    • 4
  • Katherine S. Panageas
    • 2
  • Anne S. Reiner
    • 2
  • Jason T. Huse
    • 3
  • Elena Pentsova
    • 1
  • Stephanie G. Braunthal
    • 1
  • Lauren E. Abrey
    • 1
    • 5
  • Lisa M. DeAngelis
    • 1
  • Andrew B. Lassman
    • 1
    • 6
  1. 1.Department of NeurologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  2. 2.Department of Epidemiology & BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkUSA
  3. 3.Department of PathologyMemorial Sloan Kettering Cancer CenterNew YorkUSA
  4. 4.Center for Neuro-OncologyDana-Farber/Brigham and Women’s Cancer CenterBostonUSA
  5. 5.Department of NeurologyUniversity of ZurichZurichSwitzerland
  6. 6.Department of Neurology and Herbert Irving Comprehensive Cancer CenterColumbia University Medical CenterNew YorkUSA

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