# CATNON: concurrent and adjuvant temozolomide in anaplastic glioma without 1p/19q codeletion

Source: https://onco.cc/key-papers/paper-catnon-lancet-2017/  
OnCo record `paper-catnon-lancet-2017` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Twelve cycles of temozolomide after radiotherapy lengthened survival in grade 3 glioma without 1p/19q codeletion, while giving temozolomide during radiotherapy added nothing in these tumours.

## Summary

Phase 3 factorial trial of 745 adults with newly diagnosed anaplastic glioma without 1p/19q codeletion randomised to radiotherapy alone, with concurrent temozolomide, with 12 cycles of adjuvant temozolomide, or with both.

Adjuvant temozolomide improved overall survival (hazard ratio 0.65; five-year survival 55.9 versus 44.1 percent); concurrent temozolomide did not, and later analysis showed benefit was confined to IDH-mutant tumours.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: The Lancet
- Year: 2017
- DOI: 10.1016/S0140-6736(17)31442-3
- Authors: van den Bent MJ, Baumert B, Erridge SC, et al.
- Findings: Adjuvant temozolomide: five-year overall survival 55.9 percent vs 44.1 percent; hazard ratio 0.65.; Concurrent temozolomide: no significant benefit.
- What it means: Radiotherapy followed by a year of temozolomide is the standard for grade 3 IDH-mutant astrocytoma; concurrent temozolomide is not needed, and IDH-wild-type tumours behave and are treated like glioblastoma.
- Caveats: Interim analysis; final results confirmed the pattern.; Applies to the pre-2021 category of anaplastic astrocytoma, now IDH-mutant astrocytoma grade 3.

## Sources

- Lancet 2017: https://doi.org/10.1016/S0140-6736(17)31442-3
- PubMed: https://pubmed.ncbi.nlm.nih.gov/28801186/

## Connected records

- cancers: [Astrocytoma, IDH-mutant (grades 2 to 4)](https://onco.cc/cancers/idh-mutant-astrocytoma/)
- drugs: [Temozolomide](https://onco.cc/drugs/temozolomide/)
- trials: [CATNON (EORTC 26053-22054)](https://onco.cc/trials/catnon/)
- journals: [The Lancet](https://onco.cc/journals/lancet/)

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