Wednesday 5 August 2015

Temodar schedules

I continue to ask myself how to take temozolomide. Nobody has ever studied temozolomide schedules with all the agents people take here. CUSP9 has a large dose of sertraline and not a high dose of temodar every day. If I added as much sertraline to the hudge dose of temodar on the standard schedule I am worried that there might be some toxicity. My feeling is that taking smaller doses of temodar for longer and adding all the agents would be safer and would kill more cancer cells. Kind of boosting small doses of temodar every day. Here is a study  I found. My brother is getting 2 pills a day for 5 days. I was thinking about taking one pill a day for as long as it lasts. Any comments?
http://neuro-oncology.oxfordjournals.org/content/11/1/69.full
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3 comments:

  1. Matias5 August 2015 at 15:18

    Anna, to see the correct dose of TMZ, you have to consider both the schedule you are going to follow (daily? 5/28?) and also the weight of the person. The pills you refer to have how many milligrams?

    In my case, I weight around 76kg and take TMZ for 5 days, 400mg each day, giving a total of 2g of TMZ per cycle.

    Hope it helps!

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    1. lucy6 August 2015 at 09:19

      My brother is 68 kilo. We got pills 5x140, 10x100, 15x5. I am thinking about taking one pill a day. Since there are schedules where they take 21/28 and others, and my brother's tumor is unmethylated we are thinking about just taking one pill a day and the small pills on the last day.We are not sure. Or maybe we will split some pills not sure trying to find best way. Then if I have a longer cycle of temodar I can do half of that with verapamil for example and the other half with prozac or sertraline. Not sure about all of that.

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  2. Sethman5 August 2015 at 16:19

    Thanks for the post anna. This is a very good summary of Temodar schedules. I went round and round trying to decide what to do with my Macitentan. I bought empty gel caps thinking I might cut my pills to do metronomic dosing. I buy into the concept that there is a threshold of chemo that needs to be overcome for it to be effective inside the tumor. I think this threshold is higher in my unmethylated tumor. So I am going with the high-dose 7 days on and 7 days off. I think there might be some benefit in this schedule as it gives the body 7 days to recuperate from the toxicity. But I do note that the CUSP-9 protocol is metronomic. I would really like some insight into their rational. I also note that Actelion and MD Anderson are using the 7 days on and 7 days off in their protocol.

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