Randomized phase II adjuvant factorial study of dose-dense temozolomide alone and in combination with isotretinoin, celecoxib, and/or thalidomide for glioblastoma This is a study of Temozolomide alone and in combinations with 3 different drugs that have been popular with brain tumor patients. I think this study is too small to really tell what is happening but it is interesting for 2 things:
1. The design of the trial is impressive - it is a new way to test multiple treatments. Great start and this is how trials should be run, but there were not enough people in each group.
2. Overall, there was no or minimal benefit to any combination tested over the Temodar alone. However, the group using isotretinoin (accutane) did much worse than all other combinations or even just Temodar alone. This shows that trials are always needed even when it seems to make sense to try adding something to the standard therapy. IF it is strong enough to help, it is also strong enough to hurt and a trial is the only way to tell if the benefits outweigh the risks.
There have been other trials showing a benefit to adding Accutane to the standard treatment, so more research needs to be done.
