# Temozolomide

Source: https://nuclide.cc/drugs/temozolomide/  
Nuclide record `temozolomide` (Agent). Data CC BY-NC 4.0, attribute "Data from Nuclide (nuclide.cc)"; commercial use needs a licence.

## TL;DR

The only chemotherapy proven to extend life in glioblastoma, given during and after radiation. It works best when the tumour has switched off a repair gene called MGMT.

## Summary

Stupp/EORTC 26981-NCIC (2005): adding concurrent and adjuvant temozolomide to radiotherapy raised median OS from 12.1 to 14.6 months and 2-year survival from 10% to 27%. Benefit concentrates in MGMT-promoter-methylated tumours (median OS ~23 months vs ~13 months unmethylated). Also standard with radiotherapy in grade 3 astrocytoma (CATNON) and, with PCV as an alternative, in oligodendroglioma. Oral, well tolerated; lymphopenia and hypermutation at recurrence are the costs.

## Fields

- Kind: Agent
- Status: standard-of-care
- Last checked: 2026-09-06
- Brand: Temodar
- Modality: Oral alkylating chemotherapy
- Mechanism: Prodrug of MTIC; methylates O6-guanine; cytotoxicity depends on unrepaired lesions when MGMT is silenced.
- Approvals: US 1999: Refractory anaplastic astrocytoma; US 2005: Newly diagnosed glioblastoma with radiotherapy; EU 1999: Temodal; malignant glioma (recurrent 1999; newly diagnosed glioblastoma with radiotherapy 2005); 26 Jan 1999

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Temozolomide
- Wikipedia: https://en.wikipedia.org/wiki/Temozolomide

## Connected records

- indications: [Glioma & glioblastoma](https://nuclide.cc/indications/glioblastoma/), [High-risk neuroblastoma](https://nuclide.cc/indications/neuroblastoma-high-risk/), [Metastatic pheochromocytoma and paraganglioma](https://nuclide.cc/indications/metastatic-ppgl/), [Pheochromocytoma and paraganglioma (PPGL)](https://nuclide.cc/indications/pheochromocytoma-paraganglioma/)
- companies: [Merck & Co. (MSD)](https://nuclide.cc/companies/merck/)
- trials: [Lutetium 177Lu-Edotreotide Versus Best Standard of Care in Well-differentiated Aggressive Grade-2 and Grade-3 GastroEnteroPancreatic NeuroEndocrine Tumors (GEP-NETs) - COMPOSE](https://nuclide.cc/trials/nct04919226/)
- terms: [SDH deficiency (SDHB immunohistochemistry loss)](https://nuclide.cc/terms/sdh-deficiency/)
- pairings: [PRRT (177Lu-DOTATATE) with capecitabine and temozolomide (CAPTEM)](https://nuclide.cc/pairings/prrt-plus-captem/)

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