March 4th, 2011

INTRODUCTION Malignant gliomas (glioblastoma multiforme and anaplastic astrocytoma) occur more frequently than other types of primary CNS tumors, having a combined incidence of 5–8/100,000 population. Even with aggressive treatment using surgery, radiation, and chemotherapy, median reported survival is less than 1 year . Temozolomide, a new drug, has shown promise in treating malignant gliomas and other difficult-to-treat tumors. Temozolomide represents a new class of second-generation imidazotetrazine prodrugs that undergo spontaneous conversion under physiological conditions to the active alkylating agent MTIC. Thus, temozolomide does not require hepatic metabolism for activation . Interest in temozolomide as an antitumor agent derives from its broad-spectrum antitumor activity in tumor models in mice . In vitro, temozolomide has demonstrated schedule-dependent antitumor activity against a variety of malignancies, including glioma, metastatic melanoma, and other difficult-to-treat cancers . In
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