{"entity":{"id":"paper-catnon-lancet-2017","kind":"paper","name":"CATNON: concurrent and adjuvant temozolomide in anaplastic glioma without 1p/19q codeletion","aka":[],"tldr":"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.\n\nAdjuvant 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.","asOf":"2026-09-17","links":[{"label":"Lancet 2017","url":"https://doi.org/10.1016/S0140-6736(17)31442-3"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/28801186/"}],"tags":[],"related":[],"cancers":["idh-mutant-astrocytoma"],"sections":[],"technologies":[],"targets":[],"drugs":["temozolomide"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["catnon"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["lancet"],"dependsOn":[],"notes":[],"journal":"The Lancet","year":2017,"doi":"10.1016/S0140-6736(17)31442-3","pmid":"28801186","authors":"van den Bent MJ, Baumert B, Erridge SC, et al.","paperType":"rct","findings":["Adjuvant temozolomide: five-year overall survival 55.9 percent vs 44.1 percent; hazard ratio 0.65.","Concurrent temozolomide: no significant benefit."],"whatItMeans":"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."],"changedPractice":true,"participants":745},"route":"/key-papers/paper-catnon-lancet-2017/","neighbours":{"cancer":[{"id":"idh-mutant-astrocytoma","kind":"cancer","name":"Astrocytoma, IDH-mutant (grades 2 to 4)","route":"/cancers/idh-mutant-astrocytoma/"}],"drug":[{"id":"temozolomide","kind":"drug","name":"Temozolomide","route":"/drugs/temozolomide/"}],"trial":[{"id":"catnon","kind":"trial","name":"CATNON (EORTC 26053-22054)","route":"/trials/catnon/"}],"journal":[{"id":"lancet","kind":"journal","name":"The Lancet","route":"/journals/lancet/"}]}}