CODEL
CODEL is the intergroup trial meant to settle whether oligodendroglioma patients should get temozolomide or the older three-drug PCV combination with their radiotherapy; its first phase already showed that temozolomide on its own, without radiotherapy, lets the tumour come back sooner.
Overview
CODEL (Alliance N0577) opened in 2009 for newly diagnosed anaplastic glioma with 1p/19q codeletion, randomising to radiotherapy alone, radiotherapy with concurrent and adjuvant temozolomide, or temozolomide alone. After RTOG 9402 and EORTC 26951 showed that adding PCV chemotherapy to radiotherapy doubled survival in codeleted tumours, the radiotherapy-alone arm was closed and the trial was redesigned to compare radiotherapy with temozolomide against radiotherapy with PCV, and widened to grade 2 tumours.
The analysis of the original arms, published in 2021, found that patients treated with temozolomide alone had significantly shorter progression-free survival than those who received radiotherapy, which removed deferred radiotherapy from routine practice. The main comparison of temozolomide against PCV with radiotherapy is still accruing and following patients.
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