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Temodar

Category: Chemotherapy

Other Names: temozolomide

A triazene analog of dacarbazine with antineoplastic activity. As a cytotoxic alkylating agent, temozolomide is converted at physiologic pH to the short-lived active compound, monomethyl triazeno imidazole carboxamide (MTIC). The cytotoxicity of MTIC is due primarily to methylation of DNA at the O6 and N7 positions of guanine, resulting in inhibition of DNA replication. Unlike dacarbazine, which is metabolized to MITC only in the liver, temozolomide is metabolized to MITC at all sites. Temozolomide is administered orally and penetrates well into the central nervous system.

After two years, 26 percent of patients taking temozolomide were alive compared to just 10 percent of those who had radiation only. The median survival in the radiation-plus-temozolomide group was 14.6 months compared to 12.1 months in the radiation-alone group. Progression-free survival - the amount of time before the tumor began to grow again - was 7.2 months in the temozolomide group and 5 months in the other group.

The side effects of the combined therapy were mostly mild to moderate. Fewer than 10 percent of patients experienced a severe drop in blood counts and only three developed severe infections.

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