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 Volume 68, Number 21, May 22, 2007
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NEUROLOGY 2007;68:1831-1836
© 2007 American Academy of Neurology

Temozolomide for low-grade gliomas

Predictive impact of 1p/19q loss on response and outcome

G. Kaloshi, MD, A. Benouaich-Amiel, MD, F. Diakite, MD, S. Taillibert, MD, J. Lejeune, MSc, F. Laigle-Donadey, MD, M.-A Renard, MSc, W. Iraqi, MSc, A. Idbaih, MD, S. Paris, MSc, L. Capelle, MD, H. Duffau, MD, PhD, P. Cornu, MD, J.-M Simon, MD, K. Mokhtari, MD, M. Polivka, MD, A. Omuro, MD, A. Carpentier, MD, PhD, M. Sanson, MD, PhD, J.-Y Delattre, MD and K. Hoang-Xuan, MD, PhD

From APHP, Service de Neurologie Mazarin (G.K., A.B.-A., F.D., S.T., J.L., F.L.-D., M.-A.R., W.I., A.I., A.O., A.C., M.S., J.-Y.D., K.H.-X.), APHP, Service de Neurochirurgie (L.C., H.D., P.C.), APHP, Service de Radiothérapie (J.-M.S.), and APHP, Service de Neuropathologie (K.M.), Groupe hospitalier Pitié-Salpêtrière, Paris; INSERM U711 (A.I., S.P., A.C., M.S., J.-Y.D., K.H.-X.), Université Pierre et Marie Curie-Paris; Laboratoire Biologie des Interactions Neurone-Glie, Groupe hospitalier Pitié-Salpêtrière, Paris (A.I., S.P., A.C., M.S., J.-Y.D., K.H.-X); and APHP, Service d'Anatomopathologie (M.P.), Hôpital Lariboisière, Paris, France.

Address correspondence and reprint requests to Dr. K. Hoang-Xuan, Service de Neurologie Mazarin, Groupe Hospitalier Pitié-Salpêtrière, 47 Bd de l'Hôpital, 75651, Paris Cedex 13, France khe.hoang-xuan{at}psl.aphp.fr

Objective: To evaluate the predictive impact of chromosome 1p/19q deletions on the response and outcome of progressive low-grade gliomas (LGG) treated with up-front temozolomide (TMZ) chemotherapy.

Methods: Adult patients with measurable, progressive LGG (WHO grade II) treated with TMZ delivered at the conventional schedule (200 mg/m2/day for 5 consecutive days, repeated every 28 days) were retrospectively evaluated for response by central review of MRI-s. Chromosome 1p and 19q deletions were detected by the loss of the heterozygosity technique (LOH).

Results: A total of 149 consecutive patients were included in this retrospective, single center observational study. The median number of TMZ cycles delivered was 14 (range 2 to 30). Seventy-seven patients (53%) experienced an objective response (including 22 [15%] cases of partial response and 55 [38%] cases of minor response), 55 (37%) patients had stable disease, and 14 (10%) had a progressive disease. The median time to maximum tumor response was 12 months (range 3 to 30 months). The median progression-free survival (PFS) was 28 months (95% CI: 23.4 to 32.6). Material for genotyping was available for 86 patients. Combined 1p/19q LOH was present in 42% of the cases and was significantly associated with a higher rate (p = 0.02) and longer objective response to chemotherapy (p = 0.017), and both longer PFS (p = 4.10–5) and overall survival (p = 0.04).

Conclusion: Low-grade gliomas respond to temozolomide and loss of chromosome 1p/19q predicts both a durable chemosensitivity and a favorable outcome.

Received October 4, 2006. Accepted in final form February 7, 2007.




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