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June 7, 2004
Glioblastoma multiforme (GBM) is a fast-growing primary brain cancer that is difficult to treat. The standard treatment for GBM is surgery followed by radiation therapy. However, patients diagnosed with GBM usually have a poor prognosis (chance of recovery). Results of a recent, large, multi-institutional phase III clinical trial show that treating patients with radiation and chemotherapy improves both progression-free survival and overall survival in GBM.
"This trial shows, for the first time, that chemotherapy is effective in treating this disease," said lead author Roger Stupp, MD, of the University Hospital Multidisciplinary Oncology Center in Lausanne, Switzerland. "What is also impressive is that we saw the same result even though patients were treated in over 80 institutions throughout Europe, Canada, and Australia."
In this study, more than 500 patients with GBM were randomized into two groups. One group received standard radiation therapy, and the other group received temozolomide (TMZ [Temodar]) during and after radiation therapy. TMZ is a chemotherapy drug that has shown some promise in treating recurrent brain cancer.
After two years of follow-up, the median survival time and progression-free survival was 15 months for the patients treated with both radiation and TMZ, and 12 months for the patients who received only radiation. The percentage of patients who survived for two years or more jumped from 10% in the radiation only group to 27% in the radiation plus TMZ group. Overall, this new treatment appeared safe and well tolerated.
Dr. Stupp cautioned that although this study will probably establish a new treatment standard, most people with GBM cannot be cured. "Patients are still not cured of their disease, so we need to do more research and clinical trials," he said.
What This Means for Patients
This new treatment is not a cure for GBM, but it can extend patients' lives in a meaningful way. Many doctors have not suggested clinical trials for these patients before because of how fast these tumors grow and spread. Because of these positive results, more doctors may consider enrolling patients in clinical trials, which helps improve the treatment options overall for people with GBM.