Horm Metab Res 2009; 41(9): 703-706
DOI: 10.1055/s-0029-1224135
Humans, Clinical

© Georg Thieme Verlag KG Stuttgart · New York

Clinical Utility of Temozolomide in the Treatment of Malignant Paraganglioma: A Preliminary Report

E. L. Bravo1 , S. R. Kalmadi2 , I. Gill3 , 4
  • 1Glickman Urological & Kidney Institute, Department of Nephrology & Hypertension, Cleveland Clinic, Cleveland, OH, USA
  • 2Section of Thoracic and Gastrointestinal Malignancies, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH, USA
  • 3Present Address: Ironwood Cancer & Research Center, 695 S. Dobson Road, Chandler, AZ 85224, USA, Glickman Urological & Kidney Institute, Chairman, Department of Urology, Cleveland Clinic, Cleveland, OH, USA
  • 4Present Position: Chairman & Professor, USC Institute of Urology, University of Southern California, Los Angeles, CA 90033, USA
Further Information

Publication History

received 06.02.2009

accepted 24.04.2009

Publication Date:
17 June 2009 (online)


We report on the efficacy and safety of short-term administration of temozolomide, an inhibitor of nucleoside incorporation, in a 60-year-old woman with widespread hepatic metastases from a malignant paraganglioma. Temozolomide was orally administered in daily doses of 250 mg on days 1 to 5 and repeated every 28 days for five cycles. Clinical improvement was immediate and associated with weight gain, and further reduction in blood pressure without ortho-static intolerance. In addition, abnormal hepatic function was normalized and catecholamine production was significantly reduced. Except for mild nausea, adverse effects were virtually absent. Bone marrow function, renal function, and serum electrolytes remained normal; hemoglobin remained above 9 g/dl through treatment. The platelet count decreased but not to clinically meaningful levels. These responses allowed for a surgical debulking procedure to be performed safely without complications. The results suggest that temozolomide may be useful in presurgical preparation of patients with pheochromocytoma especially in those with widespread metastatic disease and poor physical condition. However, the present findings need confirmation in a larger study and the role of temozolomide in the long-term treatment of malignant paraganglioma/pheochromocytoma remains to be established.



E. L. Bravo

Cleveland Clinic

Department of Nephrology & Hypertension

Glickman Urological & Kidney Institute

9500 Euclid Avenue - Q7


OH 44195


Phone: +1/216/444 58 29

Fax: +1/216/444 93 78

Email: [email protected]