Sex as a biological variable in response to temozolomide

<span class="paragraphSection">Although a majority of glioblastoma (GBM) patients are males at a ratio of 3 to 2,^{<a href="#CIT0001" class="reflinks">1</a>} sex is commonly overlooked as a biological variable in research. In June 2015, the National Institutes of Health recommended the inclusion of both sexes in research studies.^{<a href="#CIT0002" class="reflinks">2</a>} Studies investigating response to temozolomide (TMZ) in male versus female patients who have diagnoses of GBM have not been conclusive. Shah et al found female sex to be a prognostic indicator of improved overall survival in a retrospective review of >3300 elderly patients who received combination TMZ and radiotherapy.^{<a href="#CIT0003" class="reflinks">3</a>} However, in a second large population review using multivariate analysis, Rusthoven et al did not find a significant difference in response to chemotherapy and radiation combination treatment between elderly male and female patients.^{<a href="#CIT0004" class="reflinks">4</a>}</span>

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