Regardless of your political persuasion, Ted Kennedy was a force in the Senate, and shaped much of the current dialogue on health care reform (in addition to many other issues over his long political career). As his treatment involved surgery at Duke and proton therapy in Boston, it may be of interest to read media reports of his treatment course:
Link to CNN article
Showing posts with label GBM. Show all posts
Showing posts with label GBM. Show all posts
Thursday, August 27, 2009
Wednesday, April 29, 2009
5 year results of Temozolomide + RT for GBM
The EORTC-NCIC trial examining temozolomide + RT for GBM is updated in the Lancet Oncology this week with 5 year results.
To review this is a randomized phase III trial examining 60 Gy RT vs 60 Gy + concurrent temozolomide and 6 months adjuvant temozolomide (TMZ). This was the first real advance in GBMs for decades and was initially presented with a 2 year OS benefit in the NEJM 2005.
To review the final 5 year results: OS was 27.2% (95% CI 22.2—32.5) at 2 years, 16.0% (12.0—20.6) at 3 years, 12.1% (8.5—16.4) at 4 years, and 9.8% (6.4—14.0) at 5 years with RT+TMZ, versus 10.9% (7.6—14.8), 4·4% (2.4—7.2), 3.0% (1.4—5.7), and 1.9% (0.6—4.4) for RT alone (HR 0.6, 95% CI 0.5—0.7; p<0·00001).
All subgroups benefited, including those >60 years of age. Methylation of the MGMT promoter predicted for the most benefit.
10% long term survival may not seem like much, but the tail on this curve supports the hypothesis that GBM (at least with MGMT methylation), is a curable disease with RT + TMZ.
To review this is a randomized phase III trial examining 60 Gy RT vs 60 Gy + concurrent temozolomide and 6 months adjuvant temozolomide (TMZ). This was the first real advance in GBMs for decades and was initially presented with a 2 year OS benefit in the NEJM 2005.
To review the final 5 year results: OS was 27.2% (95% CI 22.2—32.5) at 2 years, 16.0% (12.0—20.6) at 3 years, 12.1% (8.5—16.4) at 4 years, and 9.8% (6.4—14.0) at 5 years with RT+TMZ, versus 10.9% (7.6—14.8), 4·4% (2.4—7.2), 3.0% (1.4—5.7), and 1.9% (0.6—4.4) for RT alone (HR 0.6, 95% CI 0.5—0.7; p<0·00001).
All subgroups benefited, including those >60 years of age. Methylation of the MGMT promoter predicted for the most benefit.
10% long term survival may not seem like much, but the tail on this curve supports the hypothesis that GBM (at least with MGMT methylation), is a curable disease with RT + TMZ.
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