Use of Tegwondo, a near-continuous temozolomide regimen, in high- and low-grade gliomas.

2084 Background: We report here updated results on safety and efficacy of a near-continuous 5/7-day application (“Tegwondo”) of temozolomide (TMZ) for high- and low-grade gliomas. Methods: 47 glioma patients received 292 cycles of TMZ with individual dose adaptation: 24 patients with glioblastoma (GBM), 16 pts. with WHO III gliomas and 7 pts. with low-grade gliomas received near-continous TMZ day 1-5/7, initially at 100mg/m2 Results: Toxicity was: hematotoxicity grade ¾ (asymptomatic): 7/47 (15%); nonhematological (infections) ¾°: 4/47 Pts. (4%). Only in 2/47 patients, haematological toxicity required treatment (platelet transfusion, G-CSF). GBM-pts. (n=24) had a mean age of 55y and received a median number of 5 cycles of chemotherapy. Efficacy was: 1 complete remission (CR, 4%), 11 stable diseases (SD, 46%) and 12 progressive diseases (PD, 50%) at ≥3 months. Patients with WHO-grade 3 gliomas had a median age of 47 years. They received a median of 6 (2-12) cycles of temozolomide and achieved 1/16 CR (6%), 5 partial remissions (PR, 31%), 5 SD and 1 minimal response (MR, together 38%), and 4/16 PD (25%). Patients with low-grade gliomas had a mean age of 44 years and received a median number of 6 cycles of chemotherapy. SD for at least 1year was achieved by 5/7 pts. (71%), PR by 2/7 pts. (29%). Conclusions: We previously reported rechallenge of gliomas with dose-dense temozolomide day 1-21/28 and 1-5/7. In this series, patients were exclusively treated with the 1-5/7 (“Tegwondo” = TEmozolomide Glioma WOrkiNgday DOse-dense regimen”) schedule starting at 100 mg/m2 with individual dose adaptation. This regimen was well tolerated and could be handled easily. Of note, activity was also seen in low-grade gliomas. This may be explained by the near-continuous application of chemotherapy that provides a long-lasting presence of chemotherapy in a tumor with a low proliferation rate. We conclude that the application of temozolomide with this regimen is feasible, well tolerated and is an alternative for glioma patients with critical blood counts and with lower grades of malignancy. In view of the safe application, we consider this regimen also to be an ideal basis to be combined with other antineoplastic agents.