Pegylated-liposomal doxorubicin and oral topotecan in eight children with relapsed high-grade malignant brain tumors
Background : The combination of topoisomerase I and II chemotherapeutic agents has shown promising preclinical synergistic effects in the treatment of high-grade malignant brain tumors such as high-grade gliomas and choroid plexus carcinomas. To confirm the effectiveness of this treatment combinatio...
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container_title | Journal of neuro-oncology |
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creator | Wagner, Sabine Peters, Ove Fels, Christin Janssen, Gisela Liebeskind, Anne-Kathrin Sauerbrey, Axel Suttorp, Meinolf Hau, Peter Wolff, Johannes E. A. |
description | Background
: The combination of topoisomerase I and II chemotherapeutic agents has shown promising preclinical synergistic effects in the treatment of high-grade malignant brain tumors such as high-grade gliomas and choroid plexus carcinomas. To confirm the effectiveness of this treatment combination and determine its possible toxicity, we conducted a retrospective review of the charts of children who received the therapy.
Methods
: Patients with relapsed malignant brain tumors who were given an individualized treatment of pegylated (PEG)-liposomal doxorubicin and topotecan were included in our study. PEG-liposomal doxorubicin was given intravenously at a dosage of 30–40 mg/m
2
over 4 h once every 4 weeks. Additionally, an intravenous formulation of topotecan was given orally twice daily and was increased on an individual basis from a starting dosage of 0.3 mg/m
2
per application to a total daily dosage of 0.6 mg/m
2
.
Results
: Eight patients were included. The main toxicity (NCI-CTC) after three cycles of the combination therapy was grade IV hematotoxicity (
n
= 3); grade III hematotoxicity (
n
= 2), grade III stomatitis (
n
= 1), grade III infection (
n
= 2), grade III diarrhea (
n
= 1); and grade II dermatitis (
n
= 1). In four patients, stable disease was achieved for 9, 23, more than 24, and more than 48 weeks, respectively.
Conclusion
: The schedule of PEG-liposomal doxorubicin with 30–40 mg/m
2
every 4 weeks in combination with oral topotecan resulted in tumor response, but the toxicity was high. An individualized increasing dose of PEG-liposomal doxorubicin 10–20 mg/m
2
every two weeks is now recommended. |
doi_str_mv | 10.1007/s11060-007-9444-x |
format | Article |
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: The combination of topoisomerase I and II chemotherapeutic agents has shown promising preclinical synergistic effects in the treatment of high-grade malignant brain tumors such as high-grade gliomas and choroid plexus carcinomas. To confirm the effectiveness of this treatment combination and determine its possible toxicity, we conducted a retrospective review of the charts of children who received the therapy.
Methods
: Patients with relapsed malignant brain tumors who were given an individualized treatment of pegylated (PEG)-liposomal doxorubicin and topotecan were included in our study. PEG-liposomal doxorubicin was given intravenously at a dosage of 30–40 mg/m
2
over 4 h once every 4 weeks. Additionally, an intravenous formulation of topotecan was given orally twice daily and was increased on an individual basis from a starting dosage of 0.3 mg/m
2
per application to a total daily dosage of 0.6 mg/m
2
.
Results
: Eight patients were included. The main toxicity (NCI-CTC) after three cycles of the combination therapy was grade IV hematotoxicity (
n
= 3); grade III hematotoxicity (
n
= 2), grade III stomatitis (
n
= 1), grade III infection (
n
= 2), grade III diarrhea (
n
= 1); and grade II dermatitis (
n
= 1). In four patients, stable disease was achieved for 9, 23, more than 24, and more than 48 weeks, respectively.
Conclusion
: The schedule of PEG-liposomal doxorubicin with 30–40 mg/m
2
every 4 weeks in combination with oral topotecan resulted in tumor response, but the toxicity was high. An individualized increasing dose of PEG-liposomal doxorubicin 10–20 mg/m
2
every two weeks is now recommended.</description><identifier>ISSN: 0167-594X</identifier><identifier>EISSN: 1573-7373</identifier><identifier>DOI: 10.1007/s11060-007-9444-x</identifier><identifier>PMID: 17641821</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Administration, Oral ; Adolescent ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Brain cancer ; Brain Neoplasms - drug therapy ; Brain Neoplasms - pathology ; Brain tumors ; Carcinoma ; Carcinoma - drug therapy ; Carcinoma - pathology ; Chemotherapy ; Child ; Child, Preschool ; Children ; Choroid plexus ; Choroid Plexus Neoplasms - drug therapy ; Choroid Plexus Neoplasms - pathology ; Clinical-Patient Studies ; Dermatitis ; Diarrhea ; Disease-Free Survival ; DNA topoisomerase ; Dosage ; Dose-Response Relationship, Drug ; Doxorubicin ; Doxorubicin - administration & dosage ; Doxorubicin - analogs & derivatives ; Drug Administration Schedule ; Drug Eruptions ; Glioblastoma - drug therapy ; Glioblastoma - pathology ; Hematologic Diseases - chemically induced ; Humans ; Intravenous administration ; Medicine ; Medicine & Public Health ; Neoplasm Recurrence, Local - drug therapy ; Neurology ; Oncology ; Patients ; Polyethylene Glycols - administration & dosage ; Recurrence ; Retrospective Studies ; Stomatitis ; Stomatitis - chemically induced ; Topotecan ; Topotecan - administration & dosage ; Toxicity ; Treatment Outcome ; Tumors</subject><ispartof>Journal of neuro-oncology, 2008, Vol.86 (2), p.175-181</ispartof><rights>Springer Science+Business Media, LLC 2007</rights><rights>Springer Science+Business Media, LLC. 2008</rights><rights>Springer Science+Business Media, LLC 2007.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c428t-9ceaff3f4aa79389d7551be2b71a5538aabf4abb9d2be092eabb5da01f911cc73</citedby><cites>FETCH-LOGICAL-c428t-9ceaff3f4aa79389d7551be2b71a5538aabf4abb9d2be092eabb5da01f911cc73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11060-007-9444-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11060-007-9444-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17641821$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wagner, Sabine</creatorcontrib><creatorcontrib>Peters, Ove</creatorcontrib><creatorcontrib>Fels, Christin</creatorcontrib><creatorcontrib>Janssen, Gisela</creatorcontrib><creatorcontrib>Liebeskind, Anne-Kathrin</creatorcontrib><creatorcontrib>Sauerbrey, Axel</creatorcontrib><creatorcontrib>Suttorp, Meinolf</creatorcontrib><creatorcontrib>Hau, Peter</creatorcontrib><creatorcontrib>Wolff, Johannes E. A.</creatorcontrib><title>Pegylated-liposomal doxorubicin and oral topotecan in eight children with relapsed high-grade malignant brain tumors</title><title>Journal of neuro-oncology</title><addtitle>J Neurooncol</addtitle><addtitle>J Neurooncol</addtitle><description>Background
: The combination of topoisomerase I and II chemotherapeutic agents has shown promising preclinical synergistic effects in the treatment of high-grade malignant brain tumors such as high-grade gliomas and choroid plexus carcinomas. To confirm the effectiveness of this treatment combination and determine its possible toxicity, we conducted a retrospective review of the charts of children who received the therapy.
Methods
: Patients with relapsed malignant brain tumors who were given an individualized treatment of pegylated (PEG)-liposomal doxorubicin and topotecan were included in our study. PEG-liposomal doxorubicin was given intravenously at a dosage of 30–40 mg/m
2
over 4 h once every 4 weeks. Additionally, an intravenous formulation of topotecan was given orally twice daily and was increased on an individual basis from a starting dosage of 0.3 mg/m
2
per application to a total daily dosage of 0.6 mg/m
2
.
Results
: Eight patients were included. The main toxicity (NCI-CTC) after three cycles of the combination therapy was grade IV hematotoxicity (
n
= 3); grade III hematotoxicity (
n
= 2), grade III stomatitis (
n
= 1), grade III infection (
n
= 2), grade III diarrhea (
n
= 1); and grade II dermatitis (
n
= 1). In four patients, stable disease was achieved for 9, 23, more than 24, and more than 48 weeks, respectively.
Conclusion
: The schedule of PEG-liposomal doxorubicin with 30–40 mg/m
2
every 4 weeks in combination with oral topotecan resulted in tumor response, but the toxicity was high. An individualized increasing dose of PEG-liposomal doxorubicin 10–20 mg/m
2
every two weeks is now recommended.</description><subject>Administration, Oral</subject><subject>Adolescent</subject><subject>Antineoplastic Combined Chemotherapy Protocols - adverse effects</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Brain cancer</subject><subject>Brain Neoplasms - drug therapy</subject><subject>Brain Neoplasms - pathology</subject><subject>Brain tumors</subject><subject>Carcinoma</subject><subject>Carcinoma - drug therapy</subject><subject>Carcinoma - pathology</subject><subject>Chemotherapy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Choroid plexus</subject><subject>Choroid Plexus Neoplasms - drug therapy</subject><subject>Choroid Plexus Neoplasms - pathology</subject><subject>Clinical-Patient Studies</subject><subject>Dermatitis</subject><subject>Diarrhea</subject><subject>Disease-Free Survival</subject><subject>DNA topoisomerase</subject><subject>Dosage</subject><subject>Dose-Response Relationship, Drug</subject><subject>Doxorubicin</subject><subject>Doxorubicin - administration & dosage</subject><subject>Doxorubicin - analogs & derivatives</subject><subject>Drug Administration Schedule</subject><subject>Drug Eruptions</subject><subject>Glioblastoma - drug therapy</subject><subject>Glioblastoma - pathology</subject><subject>Hematologic Diseases - chemically induced</subject><subject>Humans</subject><subject>Intravenous administration</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Recurrence, Local - drug therapy</subject><subject>Neurology</subject><subject>Oncology</subject><subject>Patients</subject><subject>Polyethylene Glycols - administration & dosage</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Stomatitis</subject><subject>Stomatitis - chemically induced</subject><subject>Topotecan</subject><subject>Topotecan - administration & dosage</subject><subject>Toxicity</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0167-594X</issn><issn>1573-7373</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kc1q3DAUhUVpaSZpH6CbIhrITq2ubVmjZQnpDwSaRQvdCVm69ijYlivJZPL20TADgUJWOtzz3SOhQ8gH4J-Bc_klAfCWsyKZapqG7V-RDQhZM1nL-jXZcGglE6r5e0bOU7rnnDeyhrfkDGTbwLaCDcl3ODyOJqNjo19CCpMZqQv7ENfOWz9TMzsaYhnmsISM1sy0TNEPu0ztzo8u4kwffN7RiKNZEjq6KyYbonFIS5ofZjNn2kVT9vI6hZjekTe9GRO-P50X5M-3m9_XP9jtr-8_r7_eMttU28yURdP3dd8YI1W9VU4KAR1WnQQjRL01pite1ylXdchVhUULZzj0CsBaWV-Qq2PuEsO_FVPWk08Wx9HMGNakK962qgJRwMv_wPuwxrm8TVdt2xSqFW2hPr1IgRKKlx8tEBwhG0NKEXu9RD-Z-KiB60Nr-tiaPshDa3pfdj6egtduQve8caqpANURSMWaB4zPN7-c-gRqjKU8</recordid><startdate>2008</startdate><enddate>2008</enddate><creator>Wagner, Sabine</creator><creator>Peters, Ove</creator><creator>Fels, Christin</creator><creator>Janssen, Gisela</creator><creator>Liebeskind, Anne-Kathrin</creator><creator>Sauerbrey, Axel</creator><creator>Suttorp, Meinolf</creator><creator>Hau, Peter</creator><creator>Wolff, Johannes E. A.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>2008</creationdate><title>Pegylated-liposomal doxorubicin and oral topotecan in eight children with relapsed high-grade malignant brain tumors</title><author>Wagner, Sabine ; Peters, Ove ; Fels, Christin ; Janssen, Gisela ; Liebeskind, Anne-Kathrin ; Sauerbrey, Axel ; Suttorp, Meinolf ; Hau, Peter ; Wolff, Johannes E. A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c428t-9ceaff3f4aa79389d7551be2b71a5538aabf4abb9d2be092eabb5da01f911cc73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Administration, Oral</topic><topic>Adolescent</topic><topic>Antineoplastic Combined Chemotherapy Protocols - adverse effects</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Brain cancer</topic><topic>Brain Neoplasms - drug therapy</topic><topic>Brain Neoplasms - pathology</topic><topic>Brain tumors</topic><topic>Carcinoma</topic><topic>Carcinoma - drug therapy</topic><topic>Carcinoma - pathology</topic><topic>Chemotherapy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Choroid plexus</topic><topic>Choroid Plexus Neoplasms - drug therapy</topic><topic>Choroid Plexus Neoplasms - pathology</topic><topic>Clinical-Patient Studies</topic><topic>Dermatitis</topic><topic>Diarrhea</topic><topic>Disease-Free Survival</topic><topic>DNA topoisomerase</topic><topic>Dosage</topic><topic>Dose-Response Relationship, Drug</topic><topic>Doxorubicin</topic><topic>Doxorubicin - administration & dosage</topic><topic>Doxorubicin - analogs & derivatives</topic><topic>Drug Administration Schedule</topic><topic>Drug Eruptions</topic><topic>Glioblastoma - drug therapy</topic><topic>Glioblastoma - pathology</topic><topic>Hematologic Diseases - chemically induced</topic><topic>Humans</topic><topic>Intravenous administration</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Recurrence, Local - drug therapy</topic><topic>Neurology</topic><topic>Oncology</topic><topic>Patients</topic><topic>Polyethylene Glycols - administration & dosage</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Stomatitis</topic><topic>Stomatitis - chemically induced</topic><topic>Topotecan</topic><topic>Topotecan - administration & dosage</topic><topic>Toxicity</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wagner, Sabine</creatorcontrib><creatorcontrib>Peters, Ove</creatorcontrib><creatorcontrib>Fels, Christin</creatorcontrib><creatorcontrib>Janssen, Gisela</creatorcontrib><creatorcontrib>Liebeskind, Anne-Kathrin</creatorcontrib><creatorcontrib>Sauerbrey, Axel</creatorcontrib><creatorcontrib>Suttorp, Meinolf</creatorcontrib><creatorcontrib>Hau, Peter</creatorcontrib><creatorcontrib>Wolff, Johannes E. A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Central (New)</collection><collection>ProQuest One Academic (New)</collection><collection>ProQuest Health & Medical Research Collection</collection><collection>ProQuest One Academic Middle East (New)</collection><collection>ProQuest One Health & Nursing</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Journal of neuro-oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wagner, Sabine</au><au>Peters, Ove</au><au>Fels, Christin</au><au>Janssen, Gisela</au><au>Liebeskind, Anne-Kathrin</au><au>Sauerbrey, Axel</au><au>Suttorp, Meinolf</au><au>Hau, Peter</au><au>Wolff, Johannes E. A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pegylated-liposomal doxorubicin and oral topotecan in eight children with relapsed high-grade malignant brain tumors</atitle><jtitle>Journal of neuro-oncology</jtitle><stitle>J Neurooncol</stitle><addtitle>J Neurooncol</addtitle><date>2008</date><risdate>2008</risdate><volume>86</volume><issue>2</issue><spage>175</spage><epage>181</epage><pages>175-181</pages><issn>0167-594X</issn><eissn>1573-7373</eissn><abstract>Background
: The combination of topoisomerase I and II chemotherapeutic agents has shown promising preclinical synergistic effects in the treatment of high-grade malignant brain tumors such as high-grade gliomas and choroid plexus carcinomas. To confirm the effectiveness of this treatment combination and determine its possible toxicity, we conducted a retrospective review of the charts of children who received the therapy.
Methods
: Patients with relapsed malignant brain tumors who were given an individualized treatment of pegylated (PEG)-liposomal doxorubicin and topotecan were included in our study. PEG-liposomal doxorubicin was given intravenously at a dosage of 30–40 mg/m
2
over 4 h once every 4 weeks. Additionally, an intravenous formulation of topotecan was given orally twice daily and was increased on an individual basis from a starting dosage of 0.3 mg/m
2
per application to a total daily dosage of 0.6 mg/m
2
.
Results
: Eight patients were included. The main toxicity (NCI-CTC) after three cycles of the combination therapy was grade IV hematotoxicity (
n
= 3); grade III hematotoxicity (
n
= 2), grade III stomatitis (
n
= 1), grade III infection (
n
= 2), grade III diarrhea (
n
= 1); and grade II dermatitis (
n
= 1). In four patients, stable disease was achieved for 9, 23, more than 24, and more than 48 weeks, respectively.
Conclusion
: The schedule of PEG-liposomal doxorubicin with 30–40 mg/m
2
every 4 weeks in combination with oral topotecan resulted in tumor response, but the toxicity was high. An individualized increasing dose of PEG-liposomal doxorubicin 10–20 mg/m
2
every two weeks is now recommended.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>17641821</pmid><doi>10.1007/s11060-007-9444-x</doi><tpages>7</tpages></addata></record> |
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language | eng |
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subjects | Administration, Oral Adolescent Antineoplastic Combined Chemotherapy Protocols - adverse effects Antineoplastic Combined Chemotherapy Protocols - therapeutic use Brain cancer Brain Neoplasms - drug therapy Brain Neoplasms - pathology Brain tumors Carcinoma Carcinoma - drug therapy Carcinoma - pathology Chemotherapy Child Child, Preschool Children Choroid plexus Choroid Plexus Neoplasms - drug therapy Choroid Plexus Neoplasms - pathology Clinical-Patient Studies Dermatitis Diarrhea Disease-Free Survival DNA topoisomerase Dosage Dose-Response Relationship, Drug Doxorubicin Doxorubicin - administration & dosage Doxorubicin - analogs & derivatives Drug Administration Schedule Drug Eruptions Glioblastoma - drug therapy Glioblastoma - pathology Hematologic Diseases - chemically induced Humans Intravenous administration Medicine Medicine & Public Health Neoplasm Recurrence, Local - drug therapy Neurology Oncology Patients Polyethylene Glycols - administration & dosage Recurrence Retrospective Studies Stomatitis Stomatitis - chemically induced Topotecan Topotecan - administration & dosage Toxicity Treatment Outcome Tumors |
title | Pegylated-liposomal doxorubicin and oral topotecan in eight children with relapsed high-grade malignant brain tumors |
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