Guidance on the use of temozolomide for the treatment of recurrent malignant glioma (brain cancer)

A randomised controlled trial of temozolomide against PCV is needed (and planned by the Cancer Research Campaign) for those with relapsed glioblastoma multiforme (GBM), anaplastic astrocytoma (AA) and other malignant gliomas. It should have sufficient power to detect a 2‑month difference in median survival time, and particular emphasis should be placed on quality of life measurement with sufficient detail on key symptoms (for example, headache, epileptic fits, rate of cognitive decline) for robust comparisons to be made.

Studies of temozolomide in combination chemotherapy (including at least 1 with an agent which diminishes the repair enzyme AGT O6‑alkylguanine‑DNA‑alkyltransferase) against other classes of chemotherapy drugs would be valuable.

Research into the effect of the drug on children is required.