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http://theoncologist.alphamedpress.org/ Temozolomide (TMZ) is the first new chemotherapy agent to be approved for the treatment of high-grade malignant gliomas in more than 20 years. This novel oral alkylating agent has demonstrated promising activity not only in brain tumors, but in a variety of solid tumors, including malignant melanoma. TMZ is 100% bioavailable when taken orally and, because of its small size and lipophilic properties, it is able to cross the blood-brain barrier. Concentrations in the central nervous system are approximately 30% of plasma concentrations. Once it has entered the central nervous system, TMZ can be spontaneously converted to the active metabolite. These pharmacologic properties make it an ideal agent for treating central nervous system malignancies. In patients with advanced metastatic melanoma, brain metastases are a major cause of treatment failure. In this setting, TMZ has been shown to be as effective as dacarbazine, with a similar safety profile. More importantly, there is evidence to suggest that TMZ-treated patients have a lower incidence of central nervous system relapse compared with dacarbazine-treated patients. Therefore, TMZ is actively being investigated for the treatment and prevention of brain metastases in melanoma patients. TMZ may become an important part of treatment regimens for advanced metastatic melanoma....
http://www.merck.com What is TEMODAR? TEMODAR (temozolomide) is a prescription medicine used to treat adults with certain brain cancer tumors. TEMODAR blocks cell growth, especially cells that grow fast, such as cancer cells. TEMODAR may decrease the size of certain brain tumors in some patients. It is not known if TEMODAR is safe and effective in children.....
http://clincancerres.aacrjournals.org The methylation of DNA seems to be the principal mechanism responsible for the cytotoxicity of temozolomide to malignant cells. The spontaneous conversion of temozolomide to the reactive methylating agent MTIC is initiated by the effect of water at the highly electropositive C4 position of temozolomide. This activity opens the ring, releases CO2, and generates MTIC (Fig. 1)? . The initial proposal was that this effect of water was catalyzed in the close environment of the major groove of DNA (26 , 27) , but confirming this mechanism has been difficult, and it is known that temozolomide converts readily to MTIC in free solution in the absence of DNA (2) . MTIC degrades to the methyldiazonium cation, which transfers the methyl group to DNA and to the final degradation product, AIC, which is excreted via the kidneys (28 , 29) . The methyldiazonium cation can also react with RNA and with soluble and cellular protein (23) . However, the methylation of RNA and the methylation or carbamoylation of protein do not appear to have any known significant role in the antitumor activity of temozolomide. Additional studies are required to clarify the role of these targets in the biochemical mechanism of action of temozolomide.... |