1 Guidance

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.