The role of temozolomide as adjuvant therapy in glioblastoma management: a systematic review and meta-analysis.

Abstract Introduction The persistent challenge of temozolomide (TMZ) resistance and the eventual recurrence of tumors underscore the need for ongoing research and the development of novel therapeutic strategies. We aim to consolidate existing evidence related to the safety and efficacy of TMZ as adj...

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Main Authors: Made Agus Mahendra Inggas, Utsav Patel, Jeremiah Hilkiah Wijaya, Nina Otinashvili, Vyshnav Rajagopal Menon, Abhay Krishnan Iyer, Tawfiq Turjman, Surbhi Dadwal, Mari Gadaevi, Azada Ismayilova, Shiva Jashwanth Gaddam, Prakriti Arya, Nihar Upadhyay, Saurabh Kataria
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-13757-1
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author Made Agus Mahendra Inggas
Utsav Patel
Jeremiah Hilkiah Wijaya
Nina Otinashvili
Vyshnav Rajagopal Menon
Abhay Krishnan Iyer
Tawfiq Turjman
Surbhi Dadwal
Mari Gadaevi
Azada Ismayilova
Shiva Jashwanth Gaddam
Prakriti Arya
Nihar Upadhyay
Saurabh Kataria
author_facet Made Agus Mahendra Inggas
Utsav Patel
Jeremiah Hilkiah Wijaya
Nina Otinashvili
Vyshnav Rajagopal Menon
Abhay Krishnan Iyer
Tawfiq Turjman
Surbhi Dadwal
Mari Gadaevi
Azada Ismayilova
Shiva Jashwanth Gaddam
Prakriti Arya
Nihar Upadhyay
Saurabh Kataria
author_sort Made Agus Mahendra Inggas
collection DOAJ
description Abstract Introduction The persistent challenge of temozolomide (TMZ) resistance and the eventual recurrence of tumors underscore the need for ongoing research and the development of novel therapeutic strategies. We aim to consolidate existing evidence related to the safety and efficacy of TMZ as adjuvant therapy to radiotherapy (RT). Methods Various electronic platforms were used to conduct a systematic literature review, including PubMed, Europe PMC, SCOPUS, and clinicaltrials.gov. The approach aimed to identify all pertinent studies published up to July 25, 2024. The search incorporated terms such as “glioblastoma,” “temozolomide,” “monotherapy,” and “adjuvant” alongside relevant Medical Subject Headings (MeSH). The key metrics were overall and progression-free survival, while secondary measures concentrated on treatment-related adverse effects, notably hematological issues like anemia, leukopenia, thrombocytopenia, and neutropenia. Results The overall effect estimates from the forest plots show significant differences favoring TMZ + RT over RT alone. The HR for overall survival is 0.64 (95% CI: 0.58, 0.71), showing a considerable improvement with TMZ + RT. Progression-free survival shows a HR of 0.51 (95% CI: 0.45, 0.58), also demonstrating a significant benefit for TMZ + RT. Conclusions Combining TMZ with RT generally leads to better overall and progression-free survival outcomes compared to RT alone. However, the two treatment groups have similar toxicity.
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spelling doaj-art-bb5ddbb263d14fefb4699183fea3a3dc2025-08-20T01:57:45ZengBMCBMC Cancer1471-24072025-03-012511810.1186/s12885-025-13757-1The role of temozolomide as adjuvant therapy in glioblastoma management: a systematic review and meta-analysis.Made Agus Mahendra Inggas0Utsav Patel1Jeremiah Hilkiah Wijaya2Nina Otinashvili3Vyshnav Rajagopal Menon4Abhay Krishnan Iyer5Tawfiq Turjman6Surbhi Dadwal7Mari Gadaevi8Azada Ismayilova9Shiva Jashwanth Gaddam10Prakriti Arya11Nihar Upadhyay12Saurabh Kataria13Department of Neurosurgery, Universitias Pelita HarpanDepartment of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolDepartment of Neurosurgery, Universitias Pelita HarpanDepartment of Medicine, Tbilisi State Medical UniversityWashington university of Health and ScienceSchool of Psychology, University of WolverhamptonDepartment of Medicine, Royal College of Surgeons in Ireland– Bahrain School of MedicineDepartment of Medicine, Dr. Rajendra Prasad Government Medical CollegeDepartment of Medicine, Tbilisi State Medical UniversityDepartment of Medicine, Azerbaijan Medical UniversityHematology/Oncology, Louisiana State University HealthDepartment of Internal Medicine, Doctors Hospital at Renaissance, University of HoustonDepartment of Medicine, GMERS Medical College and HospitalDepartment of Neurology, Louisiana State University Health Sciences Centre at ShreveportAbstract Introduction The persistent challenge of temozolomide (TMZ) resistance and the eventual recurrence of tumors underscore the need for ongoing research and the development of novel therapeutic strategies. We aim to consolidate existing evidence related to the safety and efficacy of TMZ as adjuvant therapy to radiotherapy (RT). Methods Various electronic platforms were used to conduct a systematic literature review, including PubMed, Europe PMC, SCOPUS, and clinicaltrials.gov. The approach aimed to identify all pertinent studies published up to July 25, 2024. The search incorporated terms such as “glioblastoma,” “temozolomide,” “monotherapy,” and “adjuvant” alongside relevant Medical Subject Headings (MeSH). The key metrics were overall and progression-free survival, while secondary measures concentrated on treatment-related adverse effects, notably hematological issues like anemia, leukopenia, thrombocytopenia, and neutropenia. Results The overall effect estimates from the forest plots show significant differences favoring TMZ + RT over RT alone. The HR for overall survival is 0.64 (95% CI: 0.58, 0.71), showing a considerable improvement with TMZ + RT. Progression-free survival shows a HR of 0.51 (95% CI: 0.45, 0.58), also demonstrating a significant benefit for TMZ + RT. Conclusions Combining TMZ with RT generally leads to better overall and progression-free survival outcomes compared to RT alone. However, the two treatment groups have similar toxicity.https://doi.org/10.1186/s12885-025-13757-1GlioblastomaOverall survivalProgression free survivalTemozolomide.
spellingShingle Made Agus Mahendra Inggas
Utsav Patel
Jeremiah Hilkiah Wijaya
Nina Otinashvili
Vyshnav Rajagopal Menon
Abhay Krishnan Iyer
Tawfiq Turjman
Surbhi Dadwal
Mari Gadaevi
Azada Ismayilova
Shiva Jashwanth Gaddam
Prakriti Arya
Nihar Upadhyay
Saurabh Kataria
The role of temozolomide as adjuvant therapy in glioblastoma management: a systematic review and meta-analysis.
BMC Cancer
Glioblastoma
Overall survival
Progression free survival
Temozolomide.
title The role of temozolomide as adjuvant therapy in glioblastoma management: a systematic review and meta-analysis.
title_full The role of temozolomide as adjuvant therapy in glioblastoma management: a systematic review and meta-analysis.
title_fullStr The role of temozolomide as adjuvant therapy in glioblastoma management: a systematic review and meta-analysis.
title_full_unstemmed The role of temozolomide as adjuvant therapy in glioblastoma management: a systematic review and meta-analysis.
title_short The role of temozolomide as adjuvant therapy in glioblastoma management: a systematic review and meta-analysis.
title_sort role of temozolomide as adjuvant therapy in glioblastoma management a systematic review and meta analysis
topic Glioblastoma
Overall survival
Progression free survival
Temozolomide.
url https://doi.org/10.1186/s12885-025-13757-1
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