Trial reportNeuro-oncology2016
Phase 2 study of concurrent radiotherapy and temozolomide followed by temozolomide and lomustine in the treatment of children with high-grade glioma: a report of the Children's Oncology Group ACNS0423 study.
Registry-linked trialOpen access · bronzeAbstract readClinical Trial, Phase II
In one paragraph
Trial report in Neuro-oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07243470 (A Multicenter, Open-label Phase I/II Trial Aiming to Assess the Safety and Clinical Activity of Tarlatamab in Combination With Metronomic Temozolomide in Adolescents and Adults' Patients With High Grade Brain Tumors), which is not on this map. Cited by 96 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
96citing papers in PubMed, 1 pooled it
8.1field-weighted citation impact, top 2% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
NCT07243470 phase1 / phase2recruitingnot on this mapstarted 2025, after this paper: background citation
A Multicenter, Open-label Phase I/II Trial Aiming to Assess the Safety and Clinical Activity of Tarlatamab in Combination With Metronomic Temozolomide in Adolescents and Adults' Patients With High Grade Brain Tumors
Who cites it
96 citing papers in PubMed, 1 synthesis or guideline pooled it, 178 citations in OpenAlex.
- Survival outcomes in pediatric recurrent high-grade glioma: results of a 20-year systematic review and meta-analysis.Journal of neuro-oncology · 2018Pooled it
- Phase 2 trial of veliparib, local irradiation, and temozolomide in patients with newly diagnosed high-grade glioma: a Children's Oncology Group study.Neuro-oncology · 2025Trial
- Molecular, Pathological, Radiological, and Immune Profiling of Non-brainstem Pediatric High-Grade Glioma from the HERBY Phase II Randomized Trial.Cancer cell · 2018Trial
- Natural and Synthetic Compounds, Swords for Glioblastoma Therapy: From Tumor to Its Microenvironment.International journal of molecular sciences · 2026Review
- Review
- Clinical Outcomes and Prognostic Features of Diffuse Hemispheric Glioma, H3 G34-Mutant: An International Multi-institutional Study.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Article
- Imaging assessment of immunotherapy in pediatric brain tumors.Journal of neuro-oncology · 2026Review
- Pediatric H3 G34-mutant diffuse hemispheric glioma: clinical, imaging and molecular prognostic factors, MGMT expression, and temozolomide response.Acta neuropathologica · 2026Article
- Clinical and translational progress in oncolytic virotherapy for pediatric CNS tumors.Journal of neuro-oncology · 2026Review
- The potential and risks of FLASH radiotherapy in pediatric patients.Neuro-oncology pediatrics · 2026Review
- Family and Physician Perspectives: Unassailable, a p53 and PIK3CA Mutant Glioblastoma in a Child.Current oncology (Toronto, Ont.) · 2025Article
- Comprehensive characterization and targeted treatment of a pediatric epithelioid glioblastoma with a rare TRIM24-NTRK2 fusion.NPJ precision oncology · 2025Article
- Revisiting an old therapy for new, promising combinations: Biology and perspectives of lomustine in glioma treatment.Neuro-oncology · 2025Review
- Severe Chemoradiotherapy Toxicity in a Pediatric Patient with Leigh Syndrome and Grade IV Isocitrate Dehydrogenase-Mutant Astrocytoma: A Case Report.The American journal of case reports · 2025Article
- Targeted Inhibition in Pediatric MET and ALK-Altered Hemispheric Gliomas: Objective Responses Followed by Treatment Resistance.International journal of molecular sciences · 2025Article
- Design, Conduct, and Analysis of Externally Controlled Trials.JAMA network open · 2025Article
- A peptide vaccine targeting the CMV antigen pp65 in children and young adults with recurrent high-grade glioma and medulloblastoma: a phase 1 trial.Nature cancer · 2025Article
- Novel Strategies for Improved Treatment of O6-Methylguanine-DNA Methyltransferase Promoter-Methylated Glioma.Medical research archives · 2025Article
- Old Tools in a New Era: The Continued Relevance of Chemotherapy in Pediatric Neuro-Oncology.Current oncology (Toronto, Ont.) · 2025Review
- Association of tumor treating fields (TTFields) therapy with overall survival in newly diagnosed glioblastoma.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Review
36 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
12 authors at 8 institutions in 1 country.
Regina I JakackiDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.).
Kenneth J CohenDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.).
Allen BuxtonDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.).
Mark D KrailoDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.).
Peter C BurgerDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.).
Marc K RosenblumDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.).
Daniel J BratDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.).
Ronald L HamiltonDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.).
Sandrah P EckelDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.).
Tianni ZhouDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.).
Robert S LaveyDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.).
Ian F PollackDepartments of Pediatrics (R.I.J.), Pathology (R.L.H.) and Neurosurgery (I.F.P.), University of Pittsburgh School of Medicine, Pittsburgh, PA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland (K.J.C.); Children's Oncology Group, Operations Office, Monrovia, California (A.B., M.D.K.); Department of Preventive Medicine, University of Southern California, Los Angeles, California (M.D.K, S.P.E.); Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland (P.C.B.); Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (M.K.R.); Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia (D.J.B.); Department of Mathematics and Statistics, California State University, Long Beach, California (T.Z.); Maurer Family Cancer Care Center, Bowling Green, Ohio (R.S.L.) ian.pollack@chp.edu.
California State University, Long Beach · USJohns Hopkins Medicine · USMemorial Sloan Kettering Cancer Center · USSidney Kimmel Comprehensive Cancer Center · USChildren's Oncology Group · USEmory University · USUniversity of Pittsburgh · USUniversity of Southern California · US
Funding
NCTN BIQSFP ANBL1531 (NRT)U10CA180886 · NCI · PUBLIC HEALTH INSTITUTE · PI Douglas S. Hawkins · 2014 to 2026
$390.6MX-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Elisa de Stanchina · 1985 to 2026
$347.4MCOG FOREIGN ACCRUALU10CA098543 · NCI · NATIONAL CHILDHOOD CANCER FOUNDATION · PI ADAMSON, PETER C. · 2003 to 2013
$335.5MCOG SDMC - Statistics CoreU10CA180899 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI TODD A ALONZO · 2014 to 2026
$132.8MMOLECULAR MARKERS AS PREDICTORS OF OUTCOME IN GLIOMASR01NS037704 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI POLLACK, IAN F. · 1998 to 2015
$4.5MNCI NIH HHS P30 CA008748NCI NIH HHS U10 CA098543NCI NIH HHS U10 CA180886NCI NIH HHS U10 CA180899NINDS NIH HHS R01 NS037704
Abstract
backgroundThe prognosis for children with malignant glioma is poor. This study was designed to determine whether lomustine and temozolomide following radiotherapy and concurrent temozolomide improves event-free survival (EFS) compared with historical controls with anaplastic astrocytoma (AA) or glioblastoma (GBM) and whether survival is influenced by the expression of O6-methylguanine-DNA-methyltransferase (MGMT).
methodsFollowing maximal surgical resection, newly diagnosed children with nonmetastatic high-grade glioma underwent involved field radiotherapy with concurrent temozolomide. Adjuvant chemotherapy consisted of up to 6 cycles of lomustine 90 mg/m(2) on day 1 and temozolomide 160 mg/m(2)/day ×5 every 6 weeks.
resultsAmong the 108 eligible patients with AA or GBM, 1-year EFS was 0.49 (95% CI, 0.39-0.58), similar to the original CCG-945-based design model. However, EFS and OS were significantly improved in ACNS0423 compared with the 86 AA or GBM participants treated with adjuvant temozolomide alone in the recent ACNS0126 study (1-sided log-rank P = .019 and .019, respectively). For example, 3-year EFS was 0.22 (95% CI, 0.14-0.30) in ACNS0423 compared with 0.11 (95% CI, 0.05-0.18) in ACNS0126. Stratifying the comparison by resection extent, the addition of lomustine resulted in significantly better EFS and OS in participants without gross-total resection (P = .019 and .00085 respectively). The difference in EFS and OS was most pronounced for participants with GBM (P = .059 and 0.051, respectively), and those with MGMT overexpression (P = .00036 and .00038, respectively).
conclusionThe addition of lomustine to temozolomide as adjuvant therapy in ACNS0423 was associated with significantly improved outcome compared with the preceding COG ACNS0126 HGG study in which participants received temozolomide alone.
Indexed as
AdolescentAntineoplastic Combined Chemotherapy ProtocolsBrain NeoplasmsChemoradiotherapyChildChild, PreschoolDacarbazineDisease-Free SurvivalFemaleGliomaHumansLomustineMaleTemozolomideYoung AdultDacarbazineLomustineTemozolomideastrocytomaglioblastomalomustinepediatric high-grade gliomatemozolomide
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Registered trials
NCT07243470ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.