The CANTON trial was a four-armed study which was basically intended to ask two questions. Does the outcome of patients improve if the addition of concurrent temozolomide to radiation therapy? And is the outcome of patients improved with the addition of 12 cycles of adjuvant temozolomide in patients with anaplastic astrocytoma without a 1p/19q-codeleted lesion? We started the study back in 2007...
The CANTON trial was a four-armed study which was basically intended to ask two questions. Does the outcome of patients improve if the addition of concurrent temozolomide to radiation therapy? And is the outcome of patients improved with the addition of 12 cycles of adjuvant temozolomide in patients with anaplastic astrocytoma without a 1p/19q-codeleted lesion? We started the study back in 2007. We completed enrollment in 2015. We have had several interim reportations and now we present the final update because we are closing the study. A little bit premature, but there is a changing regulatory environment and the long duration of the follow-up, so we decided to finally close the study. We confirm in this final follow-up that we don’t see any added benefit of neither concurrent nor adjuvant temozolomide in the patients without, and with the glioma, without an IDH mutation. We see all the benefits in patients with an IDH-mutated anaplastic astrocytoma, and the benefit is really coming from the 12 cycles of adjuvant temozolomide. And sort of surprisingly, we also see that the median overall survival in the patients that receive adjuvant temozolomide is 12 and a half years. We did a sort of post hoc subset analysis, which the study is absolutely not powered. But by doing that, by comparing two groups of more than 100 patients, we absolutely don’t see any benefit of the concurrent temozolomide in the patients with an IDH mutation, if they are also receiving adjuvant temozolomide. So adjuvant temozolomide seems to explain the entire patient benefit in this study.
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