Treatment > Carboplatin / Etoposide / Ifosfamide / Temozolomide Clinical Trials

Meeting Abstract

Neoadjuvant chemotherapy with temozolamide plus ifosfamide, carboplatin and etoposide in pediatric patients with high grade astrocytomas. Phase II study

E. Lopez Aguilar, S. Delgado-Huerta, A. C. Sepulveda-Vildosola, V. Wanzke-Del-angel, H. Rodriguez-Jimenez

Hospital de Pediatria CMN SXXI IMSS, Mexico, Mexico

Central Nervous System tumors are the second most frequent malignancy in pediatric oncology, and its survival has been poor.
Temozolamide (Schering Plough) has been used in adults with some success in astrocytomas.
Our objective was to determine tumoral response to a chemotherapeutic regimen consisting on: temozolamide, carboplatin, ifosfamide and etoposide in pediatric patients with high-grade astrocytomas and to calculate overall survival and toxic effects.
We included patients less than 16 years of age with newly diagnosed astrocytoma between January 2001 and January 2002.
Every patient had normal renal and hepatic function tests and had a calculated expectancy of life greater than 16 weeks.
After informed consent of their parents or tutors, every patient received hyperhidratation, antiemetic treatment and MESNA followed by temozolamide (200mg/m2 for 5 days), carboplatin (400 mg/m2 on day 1), ifosfamide (2 gm/m2 3 days) and etoposide (100 mg/m2 3 days) every 4 weeks for 4 courses.
They all then received radiotherapy (5,500 cGy).
We included 7 patients, 5 of which were boys (M:F 2.5:1).
Mean age was 10 years.
Four were located to the brain stem and 3 were supratentorial.
Six of them were anaplasic and 1 glioblastoma multiforme.
Overall tumor reduction was 44%, with 1 complete response, 1 partial response and 2 stable diseases after the first 4 courses of chemotherapy.
Three patients died: 2 corresponding to the brain stem and 1 supratentorial.
Overall survival was 52% at 24 months.
There was no significant toxicity during the study.
Temozolamide in combination with other proven chemotherapeutic regimens such as ICE seems to be useful and secure in the treatment of high grade astrocytomas in children.

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