Temozolomide
Temozolomide (TMZ) is an oral alkylating chemotherapeutic agent widely used in the treatment of malignant brain tumors, most notably glioblastoma multiforme (GBM) and other high-grade gliomas.
Temozolomide (TMZ) is an oral alkylating chemotherapeutic agent widely used in the treatment of malignant brain tumors, most notably glioblastoma multiforme (GBM) and other high-grade gliomas. It belongs to the imidazotetrazine class of compounds and exerts its cytotoxic effect by methylating DNA at the O6 position of guanine, leading to DNA strand breaks, replication failure, and apoptosis in rapidly dividing tumor cells. The drug's ability to cross the blood-brain barrier makes it particularly valuable in neuro-oncology, where it remains a cornerstone of the Stupp protocol — concurrent (chemo)Radiotherapy followed by adjuvant TMZ cycles — established as standard of care for newly diagnosed GBM. Beyond gliomas, temozolomide is also employed in combination regimens for pediatric solid tumors, including neuroblastoma and Ewing sarcoma, reflecting its broad alkylating activity and manageable tolerability profile.
A central challenge in temozolomide-based therapy is the development of tumor resistance, which is mechanistically linked to the expression and methylation status of the MGMT promoter. MGMT (O6-methylguanine-DNA methyltransferase) directly repairs the DNA lesions induced by TMZ; tumors with an unmethylated MGMT promoter tend to express this repair enzyme at high levels, rendering TMZ less effective. Abnormal DNA damage repair pathways — including those driven by oncogenic alterations such as EGFRvIII — further complicate treatment outcomes. As a result, understanding and overcoming TMZ resistance has become one of the most active areas of contemporary neuro-oncology research.
Where the papers sit
31 papers from the last 6 months study temozolomide directly · updated from PubMed 10 Oct 2026
Study type 3 clinical trials · 4 observational · 1 human data · 21 preclinical · 2 unclassified
Themes 4 themes · 1 new direction
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Glioma Treatment and Resistance
Clinical management spans low-grade and high-grade glioma, with outcomes shaped by WHO grade and MGMT promoter methylation. Temozolomide is being tested against radiotherapy, in rechallenge strategies, and in pediatric chemoradiotherapy. Resistance and toxicity remain central concerns, alongside biomarkers such as ERP44, SLC31A1 and miR-25-3p. Local and intranasal lipid-based delivery aims to improve brain targeting and combine temozolomide with other therapies.
12 papers · 38.7%
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Temozolomide Resistance in Glioblastoma
Glioblastoma resistance research is shifting toward druggable signaling, RNA regulation and tumor-state vulnerabilities. MET-YANK2-NEDD4L, USP5-RSK1, and METTL3-CBX5 pathways sustain resistance, while circMLB-driven stress granules offer another target. Patient-derived organoids and WYZ-1 models support personalized testing, including alternatives for resistant disease. Combination strategies pair temozolomide with nNOS inhibition, siRNA delivery or photothermal therapy, but clinical translation remains open.
10 papers · 32.3%
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Glioblastoma Signaling and Sensitization
Glioblastoma research is moving toward mechanism-guided sensitization rather than temozolomide alone. O-GlcNAc signaling, YAP1-Hippo control of stemness and lipid metabolism, and UFMylation are emerging therapeutic targets. Trichodermin and alantolactone combine cell-cycle or apoptosis effects with enhanced temozolomide activity. Immune and single-cell profiling increasingly connect tumor-cell pathways with macrophage and microenvironmental responses.
7 papers · 22.6%
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Relapsed Neuroblastoma Chemoimmunotherapy
Relapsed or refractory neuroblastoma treatment centers on combining dinutuximab-based immunotherapy with cytotoxic chemotherapy. Irinotecan, vincristine and temozolomide are being evaluated in pediatric chemoimmunotherapy schedules. The main endpoints are long-term survival and progression-free survival, with age and baseline risk shaping outcomes. The small evidence base leaves the relative contribution and durability of each component unresolved.
2 papers · 6.5%
Temozolomide is repurposed as a disease-modifying treatment for Duchenne muscular dystrophy
The Duchenne muscular dystrophy study in mdx mice treats temozolomide not as an antitumor drug but as a pharmacological candidate identified by its ability to reverse an ATP6AP2-associated disease signature; administration improved motor coordination, balance, and grip strength while preserving muscle architecture and reducing necrosis and fibrosis 42594836Aug. This assigns temozolomide a role outside the set’s cancer-treatment applications and suggests a therapeutic direction in which it targets molecular and tissue features of muscular dystrophy rather than tumor cells.
Papers
The 31 papers from the last 6 months that study temozolomide directly, newest first, by theme and by study type. Study types come from PubMed publication types and MeSH headings.
By theme
Glioma Treatment and Resistance (12)
- Dual-drug conjugated ionizable lipids for nucleic acid delivery and multidimensional targeted therapy of brain tumors. International journal of pharmaceutics · 27 Sept 2026 PMID 42801996
- Intranasal Delivery of Solid Lipid Nanoparticles Loaded with Carmustine and Temozolomide for Glioblastoma Treatment in Mice. AAPS PharmSciTech · 23 Sept 2026 PMID 42778815
- Quantitative stability of MGMT promoter methylation in recurrent glioma and implications for temozolomide rechallenge. Journal of neuro-oncology · 16 Sept 2026 PMID 42747707
- ERP44 Is Associated With Poor Prognosis and Promotes Proliferation and Temozolomide Resistance in Lower-grade Glioma. Cancer genomics & proteomics · 31 Aug 2026 PMID 42674822
- Multifaceted Temozolomide Toxicity in Glioma: Detection & Care. La Clinica terapeutica · 28 Aug 2026 PMID 42664125
- Temozolomide Versus Radiotherapy as First-Line Therapy for Low-Grade Glioma: Mature Results of a Randomized Phase III Trial (EORTC 22033-26033/NCIC-CTG/TROG/MRC-CTU). Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2 Jul 2026 PMID 42391581
- Hsa-miR-25-3p Inhibition Sensitizes Patient-Derived Glioblastoma Cells to Temozolomide via β-catenin Downregulation. Cellular and molecular neurobiology · 30 May 2026 PMID 42218313
- Efficacy of chemoradiotherapy in pediatric H3K27M-mutant diffuse intrinsic pontine glioma: a study based on single-center and SEER data. Journal of neuro-oncology · 30 May 2026 PMID 42218248
- Implications of the Cuproptosis Protein SLC31A1 for the Immune Microenvironment and Temozolomide Sensitivity in Glioblastoma. Anticancer research · 27 May 2026 PMID 42203322
- Treatment patterns and outcomes in high-risk WHO grade 2 diffuse glioma: a multicentre retrospective cohort study. Journal of neuro-oncology · 20 May 2026 PMID 42159820
- [177Lu]Lu-DOTATATE PRRT and CAPTEM chemotherapy for pancreas and small bowel neuroendocrine tumours: The AGITG CONTROL NETS Multi-centre randomized trial. European journal of cancer (Oxford, England : 1990) · 16 May 2026 PMID 42142431
- Codelivery Material System of Polymer Microfiber Structures for Synergistic Localized Therapy of Glioblastoma. ACS biomaterials science & engineering · 14 May 2026 PMID 42133001
Temozolomide Resistance in Glioblastoma (10)
- METTL3 Increases Temozolomide Resistance in MGMT-Negative Glioblastoma by Enhancing CBX5 mRNA Stability in an m6A-IGF2BP2-Dependent Manner. CNS neuroscience & therapeutics · 1 Oct 2026 PMID 42817804
- USP5 stabilizes RSK1 and promotes temozolomide resistance in glioblastoma. Biochemical and biophysical research communications · 24 Aug 2026 PMID 42636771
- Targeting Temozolomide-Resistant Glioblastoma: Therapeutic Potential of Neuronal Nitric Oxide Synthase Inhibitor. Cancer medicine · 30 Jun 2026 PMID 42374654
- MET-mediated phosphorylation of YANK2 at Y282 inhibits NEDD4L-dependent SUMOylation and degradation, promoting chemoresistance in glioblastoma. Molecular biomedicine · 23 Jun 2026 PMID 42337173
- Fe3+-responsive aggregable gold nanoplatform enables siRNA-mediated chemoresistance reversal and combined photothermal-temozolomide therapy for glioblastoma. Acta biomaterialia · 18 Jun 2026 PMID 42315000
- Patient-derived organoids predict personalized drug response and reveal alternative therapeutic options in glioblastoma. Cell reports. Medicine · 11 Jun 2026 PMID 42276053
- The WYZ-1 mouse glioblastoma stem cell model: A novel preclinical tool for tumor and therapy studies. Cancer letters · 9 Jun 2026 PMID 42263837
- Dual-functional MXene-integrated GelMA microspheres for synergistic chemo/photothermal therapy: In vitro 2D/3D multi-cancer evaluation and in vivo breast cancer validation. International journal of biological macromolecules · 7 Jun 2026 PMID 42251874
- Stress granule assembly represents a therapeutic vulnerability in super-enhancer-driven circMLB-mediated glioblastoma temozolomide resistance. Cancer letters · 21 May 2026 PMID 42167397
- Comprehensive quantum chemical analysis, vibrational spectroscopy, molecular docking, ADMET, and in vitro validation studies of hydroxychloroquine-MRGPRX2 complex in IDH-wildtype glioblastoma. PloS one · 21 May 2026 PMID 42166475
Glioblastoma Signaling and Sensitization (7)
- ATP6AP2 dysregulation as a central hub in DMD pathogenesis: An integrated multi-omics and therapeutic study. International immunopharmacology · 13 Aug 2026 PMID 42594836
- Integrated profiling identifies NCOA3 as a prognostic factor in patients with glioma. Functional & integrative genomics · 13 Aug 2026 PMID 42587220
- Trichodermin exhibits potent anti-glioblastoma activity by inducing cell cycle arrest and apoptosis, suppressing invasion, and enhancing temozolomide efficacy. Journal of enzyme inhibition and medicinal chemistry · 20 Jul 2026 PMID 42474259
- Dual-targeting pharmacological UFMylation inhibition reprograms tumor and immune microenvironments to achieve long-term glioblastoma regression. Signal transduction and targeted therapy · 19 Jul 2026 PMID 42472853
- Downregulation of SLC44A4 in nasopharyngeal carcinoma is associated with malignant progression, B-cell/TLS-related immune features, and sensitivity to DNA-damaging agents. PloS one · 26 Jun 2026 PMID 42361082
- Hyperglycemia promotes O-GlcNAcylation-dependent vulnerability and modulates temozolomide response in glioblastoma. Biochemical and biophysical research communications · 5 Jun 2026 PMID 42247812
- Combination of alantolactone and temozolomide targets stemness and lipid metabolism in glioblastoma through YAP1-Hippo signaling. Brain research · 14 May 2026 PMID 42134431
Relapsed Neuroblastoma Chemoimmunotherapy (2)
- Long-Term Outcomes of Patients With Relapsed/Refractory Neuroblastoma Treated on ANBL1221: A Report From the Children's Oncology Group. Pediatric blood & cancer · 23 Jul 2026 PMID 42487540
- An open-label, two-cohort, phase 1a/b study of weekly irinotecan hydrochloride liposome injection combined with vincristine and temozolomide (NALIRI-VT) in patients with advanced Ewing sarcoma. European journal of cancer (Oxford, England : 1990) · 22 Apr 2026 PMID 42019227
By study type
Clinical trials (3)
- Temozolomide Versus Radiotherapy as First-Line Therapy for Low-Grade Glioma: Mature Results of a Randomized Phase III Trial (EORTC 22033-26033/NCIC-CTG/TROG/MRC-CTU). Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2 Jul 2026 PMID 42391581
- [177Lu]Lu-DOTATATE PRRT and CAPTEM chemotherapy for pancreas and small bowel neuroendocrine tumours: The AGITG CONTROL NETS Multi-centre randomized trial. European journal of cancer (Oxford, England : 1990) · 16 May 2026 PMID 42142431
- An open-label, two-cohort, phase 1a/b study of weekly irinotecan hydrochloride liposome injection combined with vincristine and temozolomide (NALIRI-VT) in patients with advanced Ewing sarcoma. European journal of cancer (Oxford, England : 1990) · 22 Apr 2026 PMID 42019227
Observational studies and case reports (4)
- Multifaceted Temozolomide Toxicity in Glioma: Detection & Care. La Clinica terapeutica · 28 Aug 2026 PMID 42664125
- Long-Term Outcomes of Patients With Relapsed/Refractory Neuroblastoma Treated on ANBL1221: A Report From the Children's Oncology Group. Pediatric blood & cancer · 23 Jul 2026 PMID 42487540
- Efficacy of chemoradiotherapy in pediatric H3K27M-mutant diffuse intrinsic pontine glioma: a study based on single-center and SEER data. Journal of neuro-oncology · 30 May 2026 PMID 42218248
- Treatment patterns and outcomes in high-risk WHO grade 2 diffuse glioma: a multicentre retrospective cohort study. Journal of neuro-oncology · 20 May 2026 PMID 42159820
Human data, design not indexed (1)
- Quantitative stability of MGMT promoter methylation in recurrent glioma and implications for temozolomide rechallenge. Journal of neuro-oncology · 16 Sept 2026 PMID 42747707
Preclinical: animal, cell and lab studies (21)
- METTL3 Increases Temozolomide Resistance in MGMT-Negative Glioblastoma by Enhancing CBX5 mRNA Stability in an m6A-IGF2BP2-Dependent Manner. CNS neuroscience & therapeutics · 1 Oct 2026 PMID 42817804
- Intranasal Delivery of Solid Lipid Nanoparticles Loaded with Carmustine and Temozolomide for Glioblastoma Treatment in Mice. AAPS PharmSciTech · 23 Sept 2026 PMID 42778815
- ERP44 Is Associated With Poor Prognosis and Promotes Proliferation and Temozolomide Resistance in Lower-grade Glioma. Cancer genomics & proteomics · 31 Aug 2026 PMID 42674822
- USP5 stabilizes RSK1 and promotes temozolomide resistance in glioblastoma. Biochemical and biophysical research communications · 24 Aug 2026 PMID 42636771
- Integrated profiling identifies NCOA3 as a prognostic factor in patients with glioma. Functional & integrative genomics · 13 Aug 2026 PMID 42587220
- Trichodermin exhibits potent anti-glioblastoma activity by inducing cell cycle arrest and apoptosis, suppressing invasion, and enhancing temozolomide efficacy. Journal of enzyme inhibition and medicinal chemistry · 20 Jul 2026 PMID 42474259
- Dual-targeting pharmacological UFMylation inhibition reprograms tumor and immune microenvironments to achieve long-term glioblastoma regression. Signal transduction and targeted therapy · 19 Jul 2026 PMID 42472853
- Targeting Temozolomide-Resistant Glioblastoma: Therapeutic Potential of Neuronal Nitric Oxide Synthase Inhibitor. Cancer medicine · 30 Jun 2026 PMID 42374654
- Downregulation of SLC44A4 in nasopharyngeal carcinoma is associated with malignant progression, B-cell/TLS-related immune features, and sensitivity to DNA-damaging agents. PloS one · 26 Jun 2026 PMID 42361082
- MET-mediated phosphorylation of YANK2 at Y282 inhibits NEDD4L-dependent SUMOylation and degradation, promoting chemoresistance in glioblastoma. Molecular biomedicine · 23 Jun 2026 PMID 42337173
- Fe3+-responsive aggregable gold nanoplatform enables siRNA-mediated chemoresistance reversal and combined photothermal-temozolomide therapy for glioblastoma. Acta biomaterialia · 18 Jun 2026 PMID 42315000
- Patient-derived organoids predict personalized drug response and reveal alternative therapeutic options in glioblastoma. Cell reports. Medicine · 11 Jun 2026 PMID 42276053
- The WYZ-1 mouse glioblastoma stem cell model: A novel preclinical tool for tumor and therapy studies. Cancer letters · 9 Jun 2026 PMID 42263837
- Dual-functional MXene-integrated GelMA microspheres for synergistic chemo/photothermal therapy: In vitro 2D/3D multi-cancer evaluation and in vivo breast cancer validation. International journal of biological macromolecules · 7 Jun 2026 PMID 42251874
- Hyperglycemia promotes O-GlcNAcylation-dependent vulnerability and modulates temozolomide response in glioblastoma. Biochemical and biophysical research communications · 5 Jun 2026 PMID 42247812
- Hsa-miR-25-3p Inhibition Sensitizes Patient-Derived Glioblastoma Cells to Temozolomide via β-catenin Downregulation. Cellular and molecular neurobiology · 30 May 2026 PMID 42218313
- Implications of the Cuproptosis Protein SLC31A1 for the Immune Microenvironment and Temozolomide Sensitivity in Glioblastoma. Anticancer research · 27 May 2026 PMID 42203322
- Stress granule assembly represents a therapeutic vulnerability in super-enhancer-driven circMLB-mediated glioblastoma temozolomide resistance. Cancer letters · 21 May 2026 PMID 42167397
- Comprehensive quantum chemical analysis, vibrational spectroscopy, molecular docking, ADMET, and in vitro validation studies of hydroxychloroquine-MRGPRX2 complex in IDH-wildtype glioblastoma. PloS one · 21 May 2026 PMID 42166475
- Combination of alantolactone and temozolomide targets stemness and lipid metabolism in glioblastoma through YAP1-Hippo signaling. Brain research · 14 May 2026 PMID 42134431
- Codelivery Material System of Polymer Microfiber Structures for Synergistic Localized Therapy of Glioblastoma. ACS biomaterials science & engineering · 14 May 2026 PMID 42133001
Unclassified: not yet indexed with MeSH (2)
- Dual-drug conjugated ionizable lipids for nucleic acid delivery and multidimensional targeted therapy of brain tumors. International journal of pharmaceutics · 27 Sept 2026 PMID 42801996
- ATP6AP2 dysregulation as a central hub in DMD pathogenesis: An integrated multi-omics and therapeutic study. International immunopharmacology · 13 Aug 2026 PMID 42594836
Written from 31 PubMed abstracts, each one listed by PMID above. Published: 2026-06-14. Last written: 2026-09-25 by GPT. Drafted by language models from published abstracts; not medical advice.