Pseudoprogression v. “True” Tumor Progression: Temodar® Treatments — How to Tell?


A little bit more bio-wonkish than my usual fare, here, but worthy nonetheless. Recall (on the marketing of drugs side) here that Merck’s Temodar® is locked in patent litigation with Teva over bringing a generic temozolomide to market.

This science update, on the other hand, I’ll commend to all the oncologists, other doctors and true biologists in the crowd (much of it being well-beyond my ken) — per MedScape online — do go read it all:

. . . .”In true disease progression, there is elevated perfusion or increased vascularity, as well as damage to the blood–brain barrier. This makes sense biologically, but in pseudoprogression, there is no elevation in perfusion, just damage to the blood–brain barrier caused by temozolomide. There’s no increased vascularity,” Dr. Law explained.

In the same session, Pia C. Maly Sundgren, MD, PhD, professor of radiology, Lund University, Sweden, presented the findings of her study in which she monitored physiological and environmental changes in tumor volume during treatment as a means of identifying patients with a poor treatment response or who suffer from tumor recurrence early.

“Ideally, we’d like to know if a patient is responding to treatment early on, rather than waiting 10 weeks . . ., to spare patient exposure to ineffective treatment and to avoid a delay in the trial of potentially useful second-line treatments,” said Dr. Sundgren.

Dr. Sundgren’s work extends previous research conducted by a team led by Brian Ross, PhD, and Thomas Chenevert, PhD, from the University of Michigan Medical School, Ann Arbor. She presented additional data from that cohort, which shows how pseudoprogression can be identified from tumor recurrence, as described in a recent study by the same research group (J Clin Oncol. 2010;28:2293-2299). . . .

We’ll keep you apprised.

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