Fig. 3
CETEG administration and dosing. 1 CCNU is administered at a dose of 100 mg/m2 body surface area calculated according to Du Bois once every six weeks. It is recommended to be taken at least 3 h after the last meal in the morning or the evening. An antiemesis using a 5HT3 antagonist or a comparable medication should be used one hour before CCNU. The capsules should be swallowed whole and not opened or dissolved. If the dose is missed it can be taken within 48 hours of the usual starting day, but the interval to the first dose of TMZ needs to be maintained. 2 The first cycle of temozolomide is administered at the dose of 100 mg/m2. It will be taken once daily (QD) at 100 mg per m2 body surface area calculated according to Du Bois on days 2–6 of a 42 days cycle, fasting in the morning. An antiemesis using a 5HT3 antagonist or a comparable medication should be used one hour before temozolomide. The capsule should be swallowed whole and not opened or dissolved. If a dose is missed it can be taken within 6 hours of the usual morning dose. If the time is greater than 6 hours than the regular time or the patient vomits the dose, the patient should wait and take the next dose. The dose is escalated to 150 mg/m2 and 200 mg/m2 as of subsequent cycles in the absence of toxicity. 3 Follow these procedures for pseudoprogression: a) if pseudoprogression is felt to be present, treatment should continue and functional imaging (i.e., MRI perfusion, spectroscopy) or pathological confirmation should be considered; b) if pseudoprogression is known to be present, continue treatment per study protocol; c) if tumor progression is present, the patient should be discontinued from the study; d) if equivocal, contact the study PI. 4Treatment cycles are about 6 weeks long each