Extended Duration of Adjuvant Temozolomide in Glioblastoma Multiforme - A Review of Trials

Surgical resection followed by concurrent radiation therapy and temozolomide (TMZ) chemotherapy then adjuvant TMZ is the current standard treatment for glioblastoma multiforme (GBM). There is a lot of controversy regarding the duration of adjuvant TMZ. The standard guidelines recommend 6 months of adjuvant treatment, however in clinical practice in a lot of centers around the world, TMZ therapy is continued beyond 6 months duration. In this review article we will discuss both favorable and unfavorable trials regarding extended TMZ therapy and try to analyze in whom extended TMZ therapy is beneficial and whether or not it should be offered.