# NOA-08

Source: https://onco.cc/trials/noa-08/  
OnCo record `noa-08` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

NOA-08 showed that older people with glioblastoma can be treated with temozolomide tablets instead of six weeks of radiotherapy without living less long, and that the MGMT test tells you which to choose: chemotherapy if the gene is methylated, radiotherapy if it is not.

## Summary

NOA-08 (Methusalem) was a randomised phase 3 non-inferiority trial of the German Neuro-oncology Working Group in 412 patients over 65 with anaplastic astrocytoma or glioblastoma. Patients received dose-dense temozolomide 100 mg/m2 one week on, one week off, or radiotherapy of 60 Gy; 373 were treated and analysed. The primary endpoint was overall survival.

Median overall survival was 8.6 months with temozolomide and 9.6 months with radiotherapy (hazard ratio 1.09), meeting the non-inferiority margin, and event-free survival did not differ. MGMT promoter methylation predicted longer survival overall and, critically, predicted which treatment worked: event-free survival was 8.4 months with temozolomide against 4.6 with radiotherapy in methylated tumours, and 3.3 against 4.6 months in unmethylated tumours. With the Nordic trial, NOA-08 is why the corpus's glioblastoma page chooses between temozolomide alone and radiotherapy alone by MGMT status in older patients.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-22
- Also known as: Methusalem; NOA-8
- Tags: soc-trials
- Registry id: NCT01502241
- Phase: 3
- Setting: Patients over 65 with newly diagnosed anaplastic astrocytoma or glioblastoma and a Karnofsky score of 60 or more: dose-dense temozolomide (one week on, one week off) alone against radiotherapy alone (60 Gy), with overall survival non-inferiority as the primary endpoint and MGMT promoter methylation analysed
- Sponsor: Heidelberg University
- Enrolled: 412
- Result: Median overall survival 8.6 months with temozolomide against 9.6 months with radiotherapy (hazard ratio 1.09, non-inferior); MGMT-methylated tumours did better with temozolomide and unmethylated tumours with radiotherapy.
- Outcomes: Overall survival (non-inferiority): Dose-dense temozolomide alone 8.6 months vs Radiotherapy alone (60 Gy) 9.6 months, HR 1.09; Event-free survival: Dose-dense temozolomide alone 3.3 months vs Radiotherapy alone (60 Gy) 4.7 months, HR 1.15; Event-free survival, MGMT promoter methylated: Dose-dense temozolomide alone 8.4 months vs Radiotherapy alone (60 Gy) 4.6 months; Event-free survival, MGMT promoter unmethylated: Dose-dense temozolomide alone 3.3 months vs Radiotherapy alone (60 Gy) 4.6 months; Overall survival by MGMT status (both arms): MGMT promoter methylated 11.9 months vs MGMT promoter unmethylated 8.2 months, HR 0.62

## Sources

- ClinicalTrials.gov NCT01502241: https://clinicaltrials.gov/study/NCT01502241

## Connected records

- cancers: [Astrocytoma, IDH-mutant (grades 2 to 4)](https://onco.cc/cancers/idh-mutant-astrocytoma/), [Brain and spinal cord tumours (all types)](https://onco.cc/cancers/brain-tumours/), [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [IMRT / IGRT (modern external beam)](https://onco.cc/technologies/imrt-igrt/)
- drugs: [Temozolomide](https://onco.cc/drugs/temozolomide/)
- institutions: [Heidelberg University Hospital / NCT / DKFZ](https://onco.cc/institutions/heidelberg-nct/)
- key papers: [NOA-08: temozolomide alone versus radiotherapy alone for malignant astrocytoma in the elderly](https://onco.cc/key-papers/paper-noa-08-temozolomide-vs-radiotherapy-elderly-wick-lancet-oncol-2012/)

---
JSON: https://onco.cc/api/v1/entities/noa-08.json