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Advances in the management of glioblastoma: the role of temozolomide and MGMT testing

Authors Thomas R, Recht L, Nagpal S

Received 9 October 2012

Accepted for publication 16 November 2012

Published 27 December 2012 Volume 2013:5(1) Pages 1—9

DOI https://doi.org/10.2147/CPAA.S26586

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 6


Reena P Thomas, Lawrence Recht, Seema Nagpal

Department of Neurological Sciences, Stanford University Hospital, Stanford, CA, USA

Abstract: Glioblastoma (GB) is one of the most lethal forms of cancer, with an invasive growth pattern that requires the use of adjuvant therapies, including chemotherapy and radiation, to prolong survival. Temozolomide (TMZ) is an oral chemotherapy with a limited side effect profile that has become the standard of care in GB treatment. While TMZ has made an impact on survival, tumor recurrence and TMZ resistance remain major challenges. Molecular markers, such as O6-methylguanine-DNA methyltransferase methylation status, can be helpful in predicting tumor response to TMZ, and therefore guides clinical decision making. This review will discuss the epidemiology and possible genetic underpinnings of GB, how TMZ became the standard of care for GB patients, the pharmacology of TMZ, the practical aspects of using TMZ in clinic, and how molecular diagnostics – particularly the use of O6-methylguanine-DNA methyltransferase status – affect clinical management.

Keywords: glioblastoma, temozolomide, PredictMDx™, MGMT

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