Al's Comment:

 This is a complicated study to read.  The shocking data to me is in the supplemental materials.  These show how few patients - especially the elderly - get the standard Temodar regimen.   Over half of MGMT unmethylated patients do not even get Temodar at all. Only 26% of MGMT methylated patients complete the standard schedule of Temodar and 35% do not even get any Temodar.  They did note that if you do complete the entire course of Temodar (which they say is 6 weeks during radiation then 6 months after), you have a much higher overall survival - 24.7 months in unmethylated and 36.3 months for methylated patients.   I do not know if that means there is a benefit of Temodar to unmethylated patients, or just that patients in good enough shape 6 months after radiation to take Temodar will just do better in general. Bottom line - the old standard of Temodar and radiation (without Optune)  is not really good enough and we need to find better ways forward.

Posted on: 01/07/2022

Extent of MGMT promoter methylation modifies the effect of temozolomide on overall survival in patients with glioblastoma: a regional cohort study


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