Document Detail


Response to bevacizumab, irinotecan, and temozolomide in children with relapsed medulloblastoma: a multi-institutional experience.
MedLine Citation:
PMID:  23296323     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Chemotherapy for relapsed medulloblastoma has been inadequate, and most patients succumb to disease.
METHODS: We retrospectively reviewed nine cases of relapsed medulloblastoma treated with bevacizumab, irinotecan, ± temozolomide. Patients received one to three prior therapeutic regimens. Five patients received 10 mg/kg bevacizumab and 125-150 mg/m(2) irinotecan IV every 2 weeks, with temozolomide, starting at a median dose of 150 mg/m(2) orally for 5 days monthly. Two patients received bevacizumab and irinotecan, but not temozolomide, due to provider preference. Two of nine patients received 15 mg/kg bevacizumab IV, 90 mg/m(2) irinotecan orally for five consecutive days, 100 mg/m(2)/day temozolomide IV for 5 days, and 1.5 mg/m(2) vincristine IV, each administered every 21 days.
RESULTS: Median time to progression was 11 months. Median overall survival was 13 months. Objective tumor response at 3 months was 67 %, including six patients with partial response (PR) and three patients with stable disease (SD). At 6 months, objective response was 55 %, with two patients with PR and three with complete response. Additionally, one patient had SD and three had PD. Two patients remain alive and progression free at 15 and 55 months; another is alive with disease at 20 months. Toxicities included two patients with grade III neutropenia, two with grade III thrombocytopenia, one with grade III elevation of liver function tests, and one patient with grade III diarrhea.
CONCLUSIONS: The combination of bevacizumab and irinotecan, with or without temozolomide, produces objective responses with minimal toxicity in children with recurrent medulloblastoma. Prospective clinical trials are needed to evaluate the efficacy of this strategy.
Authors:
Dolly Aguilera; Claire Mazewski; Jason Fangusaro; Tobey J MacDonald; Rene Y McNall-Knapp; Laura L Hayes; Sungjin Kim; Robert C Castellino
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-08
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  29     ISSN:  1433-0350     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-03-12     Completed Date:  2013-08-26     Revised Date:  2014-03-26    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  589-96     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antibodies, Monoclonal, Humanized / administration & dosage,  therapeutic use
Antineoplastic Combined Chemotherapy Protocols / administration & dosage,  therapeutic use*
Brain Neoplasms / drug therapy*
Camptothecin / administration & dosage,  analogs & derivatives,  therapeutic use
Child
Child, Preschool
Dacarbazine / administration & dosage,  analogs & derivatives,  therapeutic use
Drug Administration Schedule
Female
Humans
Infant
Male
Medulloblastoma / drug therapy*
Recurrence
Retrospective Studies
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R01 CA172392/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal, Humanized; 2S9ZZM9Q9V/bevacizumab; 7673326042/irinotecan; 7GR28W0FJI/Dacarbazine; 85622-93-1/temozolomide; XT3Z54Z28A/Camptothecin
Comments/Corrections

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


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