THE SINGULARITIES OF TEMOZOLOMIDE PHARMACOTHERAPEUTIC EFFECTS IN BRAIN TUMOR THERAPEUTIC APPLICATIONS

Temozolomide is the most commonly used chemotherapy drug in patients with glioblastoma, although about half of those treated are resistant to temozolomide, and some patients eventually fail. Due to the limited effectiveness of existing therapies, immunotherapy in patients with glioblastoma is under intense investigation. However, early attempts at immunotherapy in glioblastoma patients as monotherapy have had disappointing results. Therefore, combinatorial treatment strategies are being explored. Temozolomide has multiple effects on the immune system that depend on the route of administration and dosing strategy and may have unpredictable consequences for immunotherapy. Temozolomide has both direct antitumor activity and immunomodulatory properties. The timing and dose of temozolomide significantly alters its effects on immune cells and the tumor microenvironment. The effect of temozolomide on response to new treatments such as immune checkpoint inhibitors is currently unknown. The effects of temozolomide dosing and timing, as well as the inhibition of immune checkpoints, are the subject of constant attention. Combination strategies involving temozolomide and immunotherapy should be carefully considered to ensure optimal results.