Evidence map›Paper›PMID 36112301›Full record

ArticleJournal of neuro-oncology2022

Limited efficacy of temozolomide alone for astrocytoma, IDH-mutant, CNS WHO grades 2 or 3.

Jonathan Weller, Sophie Katzendobler, Jens Blobner, Frederic Thiele, Hannes Becker, Stefanie Quach, Rupert Egensperger, Maximilian Niyazi, Bogdana Suchorska, Niklas Thon and 2 more

Abstract read
In one paragraph

Article in Journal of neuro-oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jonathan WellerDepartment of Neurosurgery, Medical Center of the University of Munich, Marchioninistrasse 15, 81377, Munich, Germany. jonathan.weller@med.uni-muenchen.de.
Sophie KatzendoblerDepartment of Neurosurgery, Medical Center of the University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Jens BlobnerDepartment of Neurosurgery, Medical Center of the University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Frederic ThieleDepartment of Neurosurgery, Medical Center of the University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Hannes BeckerDepartment of Neurosurgery, University Hospital of Tubingen, Tübingen, Germany.
Stefanie QuachDepartment of Neurosurgery, Medical Center of the University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Rupert EgenspergerCenter for Neuropathology and Prion Research, Medical Center of the University of Munich, Munich, Germany.
Maximilian NiyaziDepartment of Radiotherapy and Radiation Oncology, Medical Center of the University of Munich, Munich, Germany.
Bogdana SuchorskaDepartment of Neurosurgery, Sana Hospital Duisburg, Duisburg, Germany.
Niklas ThonDepartment of Neurosurgery, Medical Center of the University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Michael WellerDepartment of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.
Joerg-Christian TonnDepartment of Neurosurgery, Medical Center of the University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe role of temozolomide chemotherapy alone in isocitrate dehydrogenase (IDH)-mutant astrocytomas has not been conclusively determined. Radiotherapy might be superior to temozolomide. Recent studies have linked temozolomide with induction of hypermutation and poor clinical course in some IDH-mutant gliomas.

methodsIn this retrospective study, 183 patients with astrocytoma, IDH-mutant, CNS WHO grade 2 or 3 and diagnosed between 2001 and 2019 were included. Patients initially monitored by wait-and-scan strategies or treated with radiotherapy or temozolomide alone were studied. Patient data were correlated with outcome. Matched pair and subgroup analyses were conducted.

resultsRadiotherapy was associated with longer progression-free survival than temozolomide (6.2 vs 3.4 years, p = 0.02) and wait-and-scan strategies (6.2 vs 4 years, p = 0.03). Patients treated with radiotherapy lived longer than patients treated with temozolomide (14.4 vs 10.7 years, p = 0.02). Survival was longer in the wait-and-scan cohort than in the temozolomide cohort (not reached vs 10.7 years, p < 0.01). Patients from the wait-and-scan cohort receiving temozolomide at first progression had significantly shorter survival times than patients treated with any other therapy at first progression (p < 0.01). Post-surgical T2 tumor volume, contrast enhancement on MRI and WHO grade were associated with overall survival in univariate analyses (p < 0.01).

conclusionThe results suggest superiority of radiotherapy over temozolomide and wait-and-scan strategies regarding progression-free survival and superiority of radiotherapy over temozolomide regarding overall survival. Our results are consistent with the notion that early temozolomide might compromise outcome in some patients.

Indexed as

AstrocytomaBrain NeoplasmsAntineoplastic Agents, AlkylatingDacarbazineHumansIsocitrate DehydrogenaseMutationRetrospective StudiesTemozolomideWorld Health OrganizationAntineoplastic Agents, AlkylatingDacarbazineIsocitrate DehydrogenaseTemozolomideAstrocytomaHypermutationRadiotherapyTemozolomide

Identifiers

PMID36112301
PMCPMC9622511

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Registered trials

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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.