Treatment > Topotecan


39th ASCO Annual Meeting. Chicago, IL. May 31-June 3, 2003. Abstract No. 429 (Clinical Study)


Abstract

Response of relapsed or refractory primary central nervous system lymphoma (PCNSL) to topotecan

A. Korfel, L. Fischer, E. Thiel

Klinikum Benjamin Franklin, Berlin, Germany

Up to 30% of immunocompetent patients with PCNSL are primarly refractory to treatment and up to 60% relapse after achieving remission.
Median survival of these patients is 2 months without treatment.
No standard salvage therapy for PCNSL could be established thus far.
The topoisomerase I inhibitor topotecan has been shown to be effective in relapsed or refractory non-Hodgkin's lymphomas.
Moreover, it is able to cross the intact blood-brain barrier.
Based on these properties, we examined the effectivity of topotecan for second-line treatment of PCNSL.
Fiveteen patients with non-AIDS-related PCNSL (7 with refractory and 8 with relapsed disease) were treated with 1.5 mg/m2/d topotecan i.v. d1-5 3-weekly.
All but one were pretreated with up to 3 high-dose methotrexate based chemotherapy regimens and 4 patients were pretreated with whole-brain irradiation (WBI).
Six patients (1 with refractory and 5 with relapsed disease) responded (3 CR, 3 PR) for an overall response rate of 40%.
One patient had stabile disease, 6 patients progressed, and one patient was not evaluable for response.
Median overall survival after starting topotecan was 6 months (range 2-30+ months).
Six patients are free of disease 6 to 30 months after diagnosis of relapse.
Four of these patients received WBI after topotecan, and in 2 no further therapy was administered.
Topotecan was generally well tolerated with hematotoxicity being the most common adverse event.
Neutropenic fever occurred in 2 patients.
Clinically relevant late neurotoxicity was observed in 2 patients.
Single-agent topotecan is an effective second-line therapy in PCNSL and warrants further investigation.

© Copyright 2003 American Society of Clinical Oncology All rights reserved worldwide

Source: http://www.asco.org/ac/1,1003,_12-002489-00_18-002003-00_19-00102875-00_29-00A,00.asp?cat=CNS+Tumors&parent=
Central+Nervous+System+Tumors&returnpid=2325&SubCat_ID=4


 

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