Temozolomide, Temodal

Temozolomide, Temodal

This patient-friendly article is about chemotherapy drug, Temozolomide (Temodal) which is a treatment for brain tumours (or, brain cancer). Temozolomide has also been used for melanoma as an alternative to dicarbazine, particularly as it is taken orally and thus eliminates the need to travel to hospital. 

The cancer drug, Temozolomide was approved by the FDA for use with Grade III astrocytomas but is nonetheless often given in the UK to people at Grade IV. A 2004 study reported in the New England Journal of Medicine showed that most glioblastoma patients who survived longer on Temozolomide had tumours in which a particular gene was turned off. Indeed, the researchers reported that they could actually identify which patients would likely benefit most from the Temozolomide treatment depending on whether a certain gene within the tumour was turned off or on.

Approved by

the Medical Board. 

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This implies, like other monoclonal antibodies, that there should be a test to identify the 20 per cent of people who would best respond to the drug. However, despite original promises, no test was developed for this drug and it was given to just about everyone in the UK with a glioma. False hope ruled the treatment programme!


Fortunately now work in America has clarified the picture:

The drug was approved by the FDA in 2005, based on a randomised clinical trial showing it extended survival by a mean 2.5 months. 

However, it is now clear that between 60 and 80% of brain tumours actually develop a ’repair factor’, MGMT (meghylguanine methyltransferase) that neutralises inbound doses of Temozolomide. 

In two different clinical studies metformin (a drug used to treat Type-2 diabetes, as it cuts good sugar) has been shown to improve the performance of Temozolomide, even extending its use and effectiveness to a wider group of people.

Similarly trials involving a herb constituent, Berberine, have also widened the use and effectiveness of Temozolomide. Berberine has anti-cancer and blood glucose reducing powers (see HERE). 

Other clinical studies have shown improved results with the simultaneous use of Clomipramine.

Although some Hospitals in America have also used Avastin, this does not seem to extend survival times.

Focus has now switched to vaccines.

Side effects of Temozolomide can include: lowered resistance to infection, bruising and bleeding, anaemia, nausea and vomiting; diarrhoea, fatigue.


Some people with brain tumours are offered the triple drug combination PCVPCV is a triple drug treatment for brain tumours and consists of Procarbazine, Carmustine and Vincristine.

The following is an extract from an article called ’The Butterfly’ and talks about both PCV and Temozolomide. Click here to go straight to the article.

Extract from ’The Butterfly’


We have a triple drug combination called PCV with a 75 per cent success rate my ex-wife and Catherine were told (I wasnt allowed to see the oncologist I was trouble).

75 per cent success at what? Surviving 5 years? Surviving 2 minutes? Living until youre 90? What? (You can see why everyone thought I was trouble).

No answer.

And here I start to show my anger and frustration.  And my sadness for the cancer patients of Britain. It is borne out of double standards and unfairness. The very same people who criticise complementary therapies under the banner headline of No Clinical Trials should put their own houses in order first and ask themselves whether they really think the clinical trial results they praise so much are worth the paper they are printed on sometimes.

Procarbazine, Carmustine and Vincristine have each been tested individually, and as a triple agent. As a triple agent in 1994 clinical trials with just 24 people, 75 per cent did see a response of some sort. I wont go in to what response or how long it lasted, as the data is almost non-existent. (Mean time before progression 15.4 months). Far more worrying is the Cedars-Sinai review on 7 such clinical trials. For example, in another 1996 trial (this time with a massive 32 patients), 91 per cent saw a response at some level. However, as they highlight

29/32 patients responded to the treatment (91%)
9/29 patients experienced hematological toxicity (31%)
10/29 patients then had delayed treatments due to treatment-induced toxicities (35%)

Worse, they stressed it was important to incorporate a strict diet regime when using PCV because some foods interact badly with the drugs causing severe health problems (apparently eggs dont go too well if you take P); and that the overall health risks in using these three drugs together are not insignificant.

Its like taking three atomic bombs to kill 100 terrorists hidden in the mountains.

Not surprisingly having seen this data now, Catherine had her white cells so destroyed by PCV that a second round of the cocktail was impossible. Even the injections she was given failed to resurrect them.  However, my mumbo jumbo of Cats Claw, Echinacea, Astragalus, Curcumin and a little organic iron did bring them back to life, which just meant the experts could try something else on her, this time, new wonder drug, Temozolomide. Same result. No positive effect yet the same destruction of her natural defence system, so she could only have one round.

Temozolomide is a drug about which there has been incredible fuss in the UK after NICE refused initially to allow (pay for) its UK use.

Again, lets look at the research:
At the American Society of Clinical Oncology (ASCO) annual meeting, New Orleans, June 7, 2004 and published in the March 10, 2005, issue of the New England Journal of Medicine, with 573 glioblastoma multiforme patients (one group having just radiotherapy, the other radiotherapy plus temozolomide):
After two years, 26 per cent of patients taking temozolomide were alive compared to just 10 percent of those who had radiation only. The median survival in the radiation-plus-temozolomide group was 14.6 months compared to 12.1 months in the radiation-alone group. Progression-free survival - the amount of time before the tumor began to grow again - was 7.2 months in the temozolomide group and 5 months in the other group.

Frankly, its a lot of fuss for a drug that does not work on everyone (actually since 2004 there is a test to determine if you are one of the lucky few  but no doctors in the UK seem to use it) and on average extends the tumour-free period by two months and 6 days.

(And did anyone spot that median progression after PCV was 15.4 months but after Temozolomide was 7.2 months??)

I do know that Temozolomide can have a great success if you are genetically in tune with its abilities. That applies to about 20 per cent of patients. Gleevec can also deliver some positive results but the research was, at one stage, turned down by the FDA. 

Go to: 10 ways to improve your chemotherapy success and reduce side-effects


Other articles that you may find interesting are:

  1. A diet for Chemotherapy
  2. Immunotherapy overview
  3. A to Z Guide to Complementary Therapies

Go to: Return to the CANCERactive drug list


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