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Temozolomide PCP Prophylaxis — SCE Medical Oncology MCQ

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HardCNS TumoursTemozolomide PCP ProphylaxisSCE Medical Oncology

A patient with newly diagnosed glioblastoma starts the 42-day phase of daily temozolomide given concurrently with focal radiotherapy. Which infection-specific prophylaxis is required during this concomitant phase?

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Correct answer: E — Pneumocystis prophylaxis with co-trimoxazole or another tolerated prophylactic agent

Daily temozolomide during focal radiotherapy carries a recognised Pneumocystis risk and requires co-trimoxazole or an appropriate alternative. Herpes-simplex prophylaxis with aciclovir during radiotherapy and temozolomide: routine HSV prophylaxis is not the infection-specific requirement of this regimen. Cytomegalovirus prophylaxis with valganciclovir during radiotherapy and temozolomide: CMV prophylaxis is not routinely required and adds marrow toxicity. Mould-active prophylaxis with posaconazole during radiotherapy and temozolomide: routine mould prophylaxis is not specified for this treatment phase. Tuberculosis prophylaxis with isoniazid during radiotherapy and temozolomide: latent-TB treatment is based on infection risk and testing, not the temozolomide schedule itself.

Reference: Temodal UK summary of product characteristics (Current UK SmPC, accessed July 2026): https://www.medicines.org.uk/emc/product/1463/smpc