Safety and Efficacy of Temozolomide Combinations in Glioblastoma Patients; A Meta-Analysis

Abstract

Globally, glioblastoma is the fetal brain tumor with the highest incidence. Patients with glioblastoma who have received a clinical diagnosis need combination therapy, which combines radiation and chemotherapy drugs that have shown promising benefits. The treatment of choice for glioblastoma, both alone and in combination, is temozolomide. Studies have shown that temozolomide combined with other medications and radiotherapy in the management of glioblastoma is effective in reducing tumor size, preventing recurrence and limiting tumor progression. The study also emphasizes the safety profile of temozolomide combinations and pathophysiology of tumor, size, growth and reoccurrence. For the meta-analysis, a detailed search of scientific literature was conducted utilizing the most relevant scientific studies published to date on the intervention of temozolomide combinations to manage Glioblastoma. A search was conducted across a number of databases including Scielo, Cochrane Central Register of Controlled Trials and PubMed. The MedCalC tool was used to do a meta-analysis in accordance with Prisma standards for odds ratio between studies, risk factor analysis and relative risk. The Cochrane Central Register of Controlled Trials, Scielo and other databases were used to retrieve a total of 1635 studies for the current analysis. The meta-analysis with three distinct parameters odds ratio, risk difference and relative risk was significant with p value <0.001 (for TMZ with other chemotherapeutic agents) and p value <0.003 (for TMZ with radiation therapy). The 95% Cl for TMZ with other chemotherapeutic agents was higher for odds ratio (2.539 to 3.466), risk difference (1.345 to 1.669) and relative risk (0.192 to 0.280) over TMZ with radiation therapy (Odds ratio 1.051 to 1.327; Risk difference 0.0116 to 0.0623 and Relative risk 1.016 to 1.100). When treating GBM, TMZ in combination with other chemotherapeutic drugs has been found to be more successful than TMZ alone. Clinical trials based on TMZ offer GBM patients with freshly diagnosed solid tumors a better survival rate.