{"entity":{"id":"temozolomide","kind":"drug","name":"Temozolomide","aka":[],"tldr":"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.","status":"standard-of-care","asOf":"2026-09-06","wikipedia":"https://en.wikipedia.org/wiki/Temozolomide","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Temozolomide"}],"tags":[],"related":[],"indications":["glioblastoma"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":["merck"],"institutions":[],"pathways":[],"terms":[],"trials":["nct04919226"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Temodar","modality":"Oral alkylating chemotherapy","mechanism":"Prodrug of MTIC; methylates O6-guanine; cytotoxicity depends on unrepaired lesions when MGMT is silenced.","approvals":[{"region":"US","year":1999,"indication":"Refractory anaplastic astrocytoma"},{"region":"US","year":2005,"indication":"Newly diagnosed glioblastoma with radiotherapy"},{"region":"EU","year":1999,"indication":"Temodal; malignant glioma (recurrent 1999; newly diagnosed glioblastoma with radiotherapy 2005); 26 Jan 1999"}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/temozolomide/","neighbours":{"indication":[{"id":"glioblastoma","kind":"indication","name":"Glioma & glioblastoma","route":"/indications/glioblastoma/"},{"id":"neuroblastoma-high-risk","kind":"indication","name":"High-risk neuroblastoma","route":"/indications/neuroblastoma-high-risk/"},{"id":"metastatic-ppgl","kind":"indication","name":"Metastatic pheochromocytoma and paraganglioma","route":"/indications/metastatic-ppgl/"},{"id":"pheochromocytoma-paraganglioma","kind":"indication","name":"Pheochromocytoma and paraganglioma (PPGL)","route":"/indications/pheochromocytoma-paraganglioma/"}],"company":[{"id":"merck","kind":"company","name":"Merck & Co. (MSD)","route":"/companies/merck/"}],"trial":[{"id":"nct04919226","kind":"trial","name":"Lutetium 177Lu-Edotreotide Versus Best Standard of Care in Well-differentiated Aggressive Grade-2 and Grade-3 GastroEnteroPancreatic NeuroEndocrine Tumors (GEP-NETs) - COMPOSE","route":"/trials/nct04919226/"}],"term":[{"id":"sdh-deficiency","kind":"term","name":"SDH deficiency (SDHB immunohistochemistry loss)","route":"/terms/sdh-deficiency/"}],"pairing":[{"id":"prrt-plus-captem","kind":"pairing","name":"PRRT (177Lu-DOTATATE) with capecitabine and temozolomide (CAPTEM)","route":"/pairings/prrt-plus-captem/"}]}}