A clinical study of irinotecan plus cyclophosphamide for advanced neuroblastoma

DU Xuyan; MIAO Lixia; SUN Yanfeng; LI Yanshan; YUAN Hailian; and LIU Qiuling

PDF(1974 KB)

Medical Journal of the Chinese People Armed Police Forces ›› 2016, Vol. 27 ›› Issue (7) : 714-718.

Orignal Article

A clinical study of irinotecan plus cyclophosphamide for advanced neuroblastoma

DU Xuyan, MIAO Lixia, SUN Yanfeng, LI Yanshan, YUAN Hailian, and LIU Qiuling

Author information +

History +

Abstract

Objective To study the clinical efficacy of irinotecan plus cyclophosphamide in children with advanced neuroblastoma (NB).Methods We summarized clinical data of 18 children with advanced neuroblastoma who were treated with irinotecan plus cyclophosphamide (observation group) between May 2008 to September 2015 in the General Hospital of Peoples Armed Forces. Another 18 cases with advanced neuroblastoma received non irinotecan plus cyclophosphamide chemotherapy were employed as control group.The efficacy and safety were reviewed.Results As of September 30,2015, The disease control rate in observation group(55.56%)was higher than that in control group(27.8%); The responsive rate in observation group (77.78%) was higher than that in control group (38.9%).The progression-free survival and overall survival of observation group (31 months,28 months) was higher than that in control group(15 months,17 months)(P<0.05).In the observation group, 15 cases were followed up for 1 year, 18 cases in the control group were followed up for 1 year. The 1 year survival rate in the observation group (100%) was higher than that in the control group (61.1%,P<0.05). The dose-limiting toxicity(DLT) included nausea, vomiting, diarrhea and other gastrointestinal symptoms and bone marrow suppression of hematology toxicity. Thrombocytopenia, anemia, elevated aminotransferase in control group were higher than that in the observation group (P<0.05).Conclusions Irinotecan combined with cyclophosphamide used for treatment of advanced NB has certain curative effects without extra side effects.

Key words

neuroblastoma / irinotecan / cyclophosphamide / curative effect / safety

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

DU Xuyan, MIAO Lixia, SUN Yanfeng, LI Yanshan, YUAN Hailian, and LIU Qiuling. A clinical study of irinotecan plus cyclophosphamide for advanced neuroblastoma[J]. Medical Journal of the Chinese People Armed Police Forces. 2016, 27(7): 714-718

References

[1] Haupt R, Garaventa A C, Parodi S, et al. Improved survival of children with neuroblastoma between 1979 and 2005: a report of the Italian Neuroblastoma Registry[J]. J Clin Oncol,2010,28(14):2331-8.
[2] Adeline S, Dhanya M, Barry P, et al.Neuroblastoma: a 20-year experience in a UK regional centre[J]. Pediatric Blood Cancer,2011,57(7):1254-1260.
[3] 张信平. 转移性结肠癌药物治疗的研究进展[J].中国新药与临床杂志,2007,26(11):868-872.
[4] Hegde S R, Weijing S, Lynch J P. Systemic and targeted therapy for advanced colon cancer[J]. Expert Rev Gastroenterol Hepatol, 2014,2(1):135-49.
[5] 张贺龙. 实体瘤疗效评价标准及演变[J]. 现代肿瘤医学,2010,05(05):839-841.
[6] Mcbride D. Immunotherapy improves survival for patients with neuroblastoma[J]. Ons Connect,2009, 24(8):17.
[7] Castel V, Segura V, Canete A. Treatment of high-risk neuroblastoma with anti-GD2 antibodies[J]. Clin Transl Oncol,2010,12(12):788-93.
[8] Simon T, Hero B, Faldum A, et al. Long term outcome of high-risk neuroblastoma patients after immunotherapy with antibody ch14.18 or oral metronomic chemotherapy[J]. Bmc Cancer,2011,11(1):1-8.
[9] 杨婷, 胡显良, 王珊. 神经母细胞瘤治疗进展[J]. 中国小儿血液与肿瘤杂志, 2015, 20(6):329-332.
[10] Ruth H, Angelika E, Tomoro H, et al. Resistance to Chemotherapy Mediated by TrkB in Neuroblastomas[J]. Cancer Res,2002,62(22):6462-6466.
[11] McWilliams N B,Hayes F A,Green A A,et al. Cyclophosphamide /doxorubicin vs. cisplatin /teniposide in the treatment of children older than 12 months of age with disseminated neuroblastoma: a Pediatric Oncology Group Randomized Phase II study[J]. Med Pediatr Oncol,1995,24( 3):176-180.
[12] Wagner L M, Villablanca J G, Stewart C F, et al. Phase I trial of oral irinotecan and temozolomide for children with relapsed high-risk neuroblastoma: a new approach to neuroblastoma therapy consortium study[J]. J Clin Oncol,2009,27(8):1290-1296.
[13] Pourquier P, Waltman J L, Urasaki Y, et al. Topoisomerase I-mediated cytotoxicity of N-methyl-N’-nitro-N-nitrosoguanidine: trapping of topoisomerase I by the O6-methylguanine[J]. Cancer Res,2001,61(1):53-58.
[14] Wagner L M, Crews K R, Iacono L C, et al. Phase I trial of temozolomide and protracted irinotecan in pediatric patients with refractory solid tumors[J].Clin Cancer Res,2004,10(3):840-848.
[15] Wagner L M, Nancy McAllister M D, Goldsby R E, et al. Temozolomide and intravenous irinotecan for treatment of advanced Ewing sarcoma[J].Pediatric Blood Cancer,2007,48(2):132–139.
[16] Houghton P J, Stewart C F, Cheshire P J, et al. Antitumor activity of temozolomide combined with irinotecan is partly independent of O6-methylguanine-DNA methyltransferase and mismatch repair phenotypes in xenograft models[J]. Clin Cancer Res,2000,6(10):4110-4118.
[17] Turner C D, Gururangan S, Eastwood J, et al. Phase II study of irinotecan (CPT-11) in children with high-risk malignant brain tumors: the Duke experience[J]. Neuro Oncol,2002,4(2):102-108.
[18] Wolfgang W, Michael W. How lymphotoxic is dose-intensified temozolomide? The glioblastoma experience[J]. J Clin Oncol, 2005,23(18):4235-42367.
[19] Kuo D J, Weiner H L, Jeffrey W, et al. Temozolomide is Active in Childhood, Progressive, Unresectable, Low-Grade Gliomas[J]. J Pediatr Hematol Oncol,2003,25(5):372-378.
[20] Kushner B H, Kim K, Shakeel M, et al. Irinotecan plus temozolomide for relapsed or refractory neuroblastoma[J]. J Clin Oncol,2006,24(33):5271-5276.