Document Detail


Phase 1 trial of O6-benzylguanine and BCNU in children with CNS tumors: a Children's Oncology Group study.
MedLine Citation:
PMID:  17941066     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Efficacy of nitrosoureas is limited by host repair of drug-induced alkylation. O(6)-benzylguanine (O(6)-BG), an inhibitor of host alkylation repair, and BCNU were studied in children with refractory/untreatable central nervous system tumors to determine dose-limiting toxicities (DLTs) and maximum tolerated dose (MTD) of BCNU administered following O(6)-BG. PROCEDURE: O(6)-BG (120 mg/m(2) IV over 1 hr) was followed by BCNU (IV over 1 hr). Cohorts of three to six patients were treated with escalating doses of BCNU. Courses were repeated every 6 weeks. Patients in Stage 1 were accrued irrespective of prior treatment. Once the MTD was exceeded, Stage II accrual was limited to less heavily pretreated patients (</= two prior chemotherapy regimens, no prior central axis radiation, no prior bone marrow transplant, and no bone marrow involvement). RESULTS: Twelve patients in Stage I and 13 in Stage II (less heavily pretreated patients only) were evaluable for toxicity. The MTD of BCNU administered with O(6)-BG (120 mg/m(2) IV) was 58 mg/m(2) in less-heavily pretreated patients. Myelosuppression, which was cumulative in some patients receiving multiple cycles of therapy, was the predominate DLT. Twenty-four patients were evaluable for response: after two courses of therapy, 6 had stable disease, 17 had progressive disease, and 1 patient had a minor response but progressed after four courses of therapy. CONCLUSIONS: Based on lack of activity of this combination in adult phase II studies, no further testing of O(6)-BG plus BCNU in children is planned. Strategies to decrease hematopoeitic toxicity of BCNU plus O(6)-BG are required.
Authors:
Denise M Adams; Tianni Zhou; Stacey L Berg; Mark Bernstein; Kathleen Neville; Susan M Blaney;
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Publication Detail:
Type:  Clinical Trial, Phase I; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pediatric blood & cancer     Volume:  50     ISSN:  1545-5017     ISO Abbreviation:  Pediatr Blood Cancer     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-01-15     Completed Date:  2008-02-12     Revised Date:  2009-01-12    
Medline Journal Info:
Nlm Unique ID:  101186624     Medline TA:  Pediatr Blood Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  549-53     Citation Subset:  IM    
Copyright Information:
(c) 2007 Wiley-Liss, Inc.
Affiliation:
Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA. Denise.Adams@cchmc.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antineoplastic Agents, Alkylating / administration & dosage,  adverse effects,  pharmacology*
Antineoplastic Combined Chemotherapy Protocols / adverse effects,  therapeutic use*
Bone Marrow Diseases / chemically induced
Carmustine / administration & dosage,  adverse effects,  pharmacology*
Central Nervous System Neoplasms / drug therapy*,  therapy
Child
Child, Preschool
Cohort Studies
Combined Modality Therapy
DNA Repair / drug effects
DNA, Neoplasm / drug effects
Enzyme Inhibitors / administration & dosage,  pharmacology,  therapeutic use
Female
Guanine / administration & dosage,  adverse effects,  analogs & derivatives*,  pharmacology
Humans
Male
Maximum Tolerated Dose
Neoplasm Proteins / antagonists & inhibitors*
O(6)-Methylguanine-DNA Methyltransferase / antagonists & inhibitors*
Salvage Therapy
Grant Support
ID/Acronym/Agency:
CA 97543/CA/NCI NIH HHS; M01 RR00188/RR/NCRR NIH HHS; U01 CA97552/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Alkylating; 0/DNA, Neoplasm; 0/Enzyme Inhibitors; 0/Neoplasm Proteins; 154-93-8/Carmustine; 19916-73-5/O(6)-benzylguanine; 73-40-5/Guanine; EC 2.1.1.63/O(6)-Methylguanine-DNA Methyltransferase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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