Temozolomide

Temozolomide is an alkylating agent. Alkylating agents are drugs that damage the DNA of cancer cells to keep them from making more copies of themselves. It works by slowing or stopping the growth of cancer cells in your body and this drug is rapidly absorbed and crosses the blood-brain barrier.

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Indications

  • Cutaneous T-cell lymphomas (mycosis fungoides and Sezary syndrome) Data from a small open-label, multicentre, phase 2 trial supports the use of temozolomide in the treatment of advanced cutaneous T-cell lymphomas (mycosis fungoides and Sezary syndrome) in patients who had failed at least one prior systemic therapy
  • Primary central nervous system lymphoma (PCNSL). There is data from a small phase 2 study supporting the use of temozolomide (in combination with methotrexate, leucovorin, and rituximab) for the treatment of newly diagnosed primary CNS lymphoma [Rubenstein 2013]. Data from a limited number of patients in two small studies suggest that temozolomide (in combination with rituximab) may be beneficial as salvage treatment of relapsed or refractory primary CNS lymphoma

Administration

  • Temozolomide comes in capsules
  • Patients should not eat anything for 2 hours before, or 1 hour after, taking the capsules.
  • They must be swallowed whole with a glass of water.
  • They should not be chewed, opened, or crushed.
  • Take the capsules at the same time every day. The doctor, nurse or pharmacist will advise when to take the capsules.

Other things to remember about taking these capsules

  • Wash your hands after touching these capsules.
  • Other people should avoid direct contact with these chemotherapy drugs and it is recommended that everyone should wear disposable gloves when handling the medication. Always wash hands after taking the gloves off.
  • Keep them in the original package and at room temperature, away from heat and direct sunlight.
  • Keep them safe and out of sight and reach of children.
  • If you are sick just after taking the capsules, contact the hospital. Do not take another dose.
  • If the treatment is stopped, return any unused capsules or tablets to the pharmacist, so they can dispose of the medication safely.

Possible side-effects

  • Nausea and vomiting
  • Fatigue
  • Constipation or diarrhoea
  • Headache
  • Loss of appetite or weight
  • Fever or high temperature
  • Rash
  • Hair loss
  • Itching
  • Dizziness, weakness
  • General body pain
  • Stomach pain, indigestion
  • Different taste sensation
  • Mouth ulcers
  • Coughing
  • Sleeplessness
For more info see
Common Side Effects
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Useful Definitions

  • Refractory: This means the lymphoma does not get better with treatment. The treatment didn’t work as hoped.
  • Relapsed: This means the lymphoma came back after being gone for a while after treatment.
  • 2nd line treatment: This is the second treatment you get if the first one didn’t work (refractory) or if the lymphoma comes back (relapse).
  • 3rd line treatment: This is the third treatment you get if the second one didn’t work or the lymphoma comes back again.
  • Approved: Available in Australia and listed by the Therapeutics Goods Administration (TGA).
  • Funded: Costs are covered for Australian citizens. This means if you have a Medicare card, you shouldn’t have to pay for the treatment.[WO7]

You need healthy T-cells to make CAR T-cells. For this reason, CAR T-cell therapy cannot be used if you have a T-cell lymphoma – yet.

For more information on CAR T-cells and T-cell lymphoma click here. 

Special Note: Although your T-cells are removed from your blood for CAR T-cell therapy, most of our T-cells live outside of our blood – in our lymph nodes, thymus, spleen and other organs.