Primary CNS lymphoma in the elderly: temozolomide therapy and MGMT status

J Neurooncol. 2010 May;97(3):389-92. doi: 10.1007/s11060-009-0032-0. Epub 2009 Oct 20.

Abstract

This retrospective series explores temozolomide monotherapy in elderly patients with primary CNS lymphoma (PCNSL) and severe comorbidities. In 17 patients (62-90 years old), the complete response rate was 47%, median progression-free survival was 5 months, and median overall survival was 21 months. Five of 17 patients (29.4%) had prolonged responses for at least 12 months and survived for more than 24 months. Three of these patients had a methylated O(6)-methylguanine-DNA methyltransferase (MGMT) promoter, while the MGMT status was not assessable in the remaining two patients. Temozolomide monotherapy appears to be effective in a subgroup of elderly PCNSL patients and deserves further evaluation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Alkylating / therapeutic use*
  • Central Nervous System Neoplasms / drug therapy*
  • Central Nervous System Neoplasms / genetics*
  • Central Nervous System Neoplasms / mortality
  • DNA Methylation / drug effects
  • DNA Modification Methylases / metabolism*
  • DNA Repair Enzymes / metabolism*
  • Dacarbazine / analogs & derivatives*
  • Dacarbazine / therapeutic use
  • Disease-Free Survival
  • Female
  • Geriatrics
  • Humans
  • Lymphoma / drug therapy*
  • Lymphoma / genetics
  • Lymphoma / metabolism
  • Male
  • Middle Aged
  • Promoter Regions, Genetic / drug effects
  • Retrospective Studies
  • Survival Analysis
  • Temozolomide
  • Tumor Suppressor Proteins / metabolism*

Substances

  • Antineoplastic Agents, Alkylating
  • Tumor Suppressor Proteins
  • Dacarbazine
  • DNA Modification Methylases
  • MGMT protein, human
  • DNA Repair Enzymes
  • Temozolomide