Title : 12 cycle vs 6 cycle adjuvant TMZ?
link : 12 cycle vs 6 cycle adjuvant TMZ?
12 cycle vs 6 cycle adjuvant TMZ?
My husband is finishing up cycle 4, our medical provider (Kaiser) does six rounds, so I'm curious if there's any benefit to seeing if more is better.I know this was discussed in 2017 - Stephen posted a link to an Indian study/review article that said 12 cycle had improved PFS/OS but with big caveats about how more studies were needed. I've now seen a more recent study looking at the comparison between 6 and 12 Extended Dosing (12 Cycles) of Adjuvant Temozolomide in Adults with Newly Diagnosed High Grade Gliomas: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines seem to draw similar conclusions, though a couple of studies in Spain say that 12 cycles is a better choice for older patients or patients with AA (not GBM).
At the time Stephen's thoughts were to 1) go for 12 rounds (or possibly more if tolerated) if the tumor is methylated and if there weren't financial means to pursue immunotherapy, and 2) with an unmethylated tumor and financial resources, stop at six rather than continue to build toxicity to bone marrow and blood counts. Since we fit in the latter category I'm thinking that the six is fine, but I wanted to see if anyone here had additional thoughts or concerns. We have no additional tumor tissue (biopsy surgery only) and didn't have the right markers for the CAR-T treatment at City of Hope, so I'm not even sure if there are vaccine options to realistically pursue.
Thoughts?
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