Technology Appraisal Guidance No. 23
Source: National Institute for Health and Care Excellence
1.1 Temozolomide is recommended as an option for treating malignant glioma, such as glioblastoma multiforme or anaplastic astrocytoma, showing recurrence or progression after standard therapy only if the person has a Karnofsky performance status score greater than or equal to 70 and a life expectancy of 12 weeks or more.
When using the Karnofsky performance status score, clinicians should be aware of the need to secure equality of access to treatment for people with disabilities. Clinicians should bear in mind that people with disabilities may have difficulties with activities of daily living that are unrelated to their prognosis for malignant glioma. For such people clinicians should make appropriate judgements about performance status, taking into account the person's usual functional capacity and need for assistance with activities of daily living.
1.2 This recommendation has been updated by recommendation 1.1 in the NICE technology appraisal guidance on carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma.
1.3 This recommendation has been updated by recommendation 1.1 in the NICE technology appraisal guidance on carmustine implants and temozolomide for the treatment of newly diagnosed high-grade glioma.
1.4 People whose treatment with temozolomide is not recommended in this NICE guidance, but was started within the NHS before this guidance was published, should be able to continue treatment until they and their NHS clinician consider it appropriate to stop.
The guidance shown above constitutes Section 1 of the full document. A copy of the full document and a summary of the evidence is available on the Internet at
This guidance represents the view of the Institute which was arrived at after careful consideration of the available evidence. Health professionals are expected to fully take it into account when exercising their clinical judgement. This guidance does not, however, override the individual responsibility of health professionals to make appropriate decisions in the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
© Copyright National Institute for Health and Care Excellence. All rights reserved. This material may be freely reproduced for educational and not for profit purposes within the NHS. No reproduction by or for commercial organisations is permitted without the express written permission of the Institute.
Enquiries concerning the guidance should be addressed to: National Institute for Health and Care Excellence, MidCity Place, 71 High Holborn, London WC1V 6NA. email:
Guidance on the Use of Temozolomide for the Treatment of Recurrent Malignant Glioma (Brain Cancer).
Issue Date: April 2001
Updated: March 2016