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Adding the chemotherapy pill temozolomide to radiation treatment significantly improves survival for adults with brain tumors known as grade 2 gliomas, a clinical trial led by a top UVA Health cancer expert has found.

The randomized, phase 3 trial followed 172 patients for more than 10 years, comparing outcomes for those who received radiation alone versus those who received radiation plus temozolomide. The median age of the participants was 44, and 54% were male.

“We found that the 10-year survival rate was 70% with the combined treatment with temozolomide chemotherapy and radiation, compared to 47% with radiation alone as the initial approach,” says lead investigator David Schiff, MD, co-director, UVA Neuro-Oncology Center at UVA Cancer Center. “This discovery is important because until now, we have not had compelling evidence that temozolomide improves overall survival in grade 2 gliomas.”

Treating Grade 2 Gliomas

The trial results are expected to have an immediate effect on how the slow-growing tumors are treated.

Since the results of another clinical trial, RTOG, came out in 2014, patients with grade 2 glioma have routinely received radiation plus chemotherapy, Schiff notes. “Some are getting PCV [chemotherapy] because that is what RTOG showed was beneficial. Others are getting radiation plus temozolomide because temozolomide is a lot easier for the oncologist to give and a lot less toxic for patients to take, and it doesn’t involve an intravenous infusion of vincristine,” he says. “But until now, there really was no supporting evidence in grade 2 gliomas that temozolomide was beneficial.” 

In addition to the benefits seen in the trial, temozolomide is less toxic than other chemotherapies for grade 2 gliomas.

Schiff presented the results of the trial as a late-breaking abstract at the Society of Neuro-Oncology’s 2024 SNO Annual Meeting in Houston. The trial, by the ECOG-ACRIN Cancer Research Group (ECOG-ACRIN), was funded by the National Institutes of Health’s National Cancer Institute through the National Clinical Trials Network.

About UVA Cancer Center

Finding better ways to treat cancer and improve patient outcomes is a primary mission of UVA Cancer Center, one of only 57 cancer centers designated as “comprehensive” by the National Cancer Institute. The designation honors elite cancer centers with the finest cancer care and research programs in the nation.