Temozolomide (TMZ) is an orally administered analogue of dacarbazine and is considered as a second-generation alkylating agent with antineoplastic activity. It exerts its effect primarily via deoxyribonucleic acid (DNA) methylation at the O6 and N7 positions of guanine leading to DNA replication inhibition. It received accelerated approval by the United States (US) Food and Drug Administration (FDA) in 1999 for the treatment of refractory anaplastic astrocytoma in adults. Subsequently it has been approved by the FDA in 2005 for treatment of newly diagnosed glioblastoma multiforme (GBM), initially in combination with radiotherapy, then as maintenance treatment. In Singapore, TMZ has been approved for use by the Health Sciences Authority (HSA) since November 2001.
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