Phase II study of carboplatin in children with progressive low-grade gliomas.

Abstract

PURPOSE:

To assess the rate of tumor response and activity of carboplatin in stabilizing the growth of progressive low-grade gliomas.

PATIENTS AND METHODS:

Eligible patients received carboplatin 560 mg/m(2) intravenously every 4 weeks for 1 year after maximum tumor response or until disease progression or unacceptable toxicity.

RESULTS:

Between October 1993 and October 2000, 81 children (median age, 79 months; range, 6 to 204) were enrolled onto this study. Patients received a median of 11 cycles of carboplatin (range, one to 29). Median follow-up from the time of enrollment was 55 months (range, 10 to 93). The overall objective response (complete response [CR] + partial response [PR] + minor response [MR]) and disease stabilization (CR + PR + stable disease + MR) rates to carboplatin treatment were 28% (95% confidence interval [CI], 18% to 38%) and 85% (95% CI, 74% to 93%), respectively. Eleven and 14 patients suffered progressive disease on study and after stopping therapy, respectively. Toxicity was predominantly myelosuppression and included grade 3/4 neutropenia in 56 patients and grade 3/4 thrombocytopenia in 40 patients. The 3-year failure-free survival (FFS) and overall survival (OS) for all patients were 64% (95% CI, 54% to 76%) and 84% (95% CI, 76% to 93%), respectively. Patients with diencephalic tumors had inferior FFS and OS compared with those with tumor at other sites (38% v 74% for FFS, P =.011; 54% v 91% for OS, P =.004). Neurofibromatosis type 1 patients with progressive low-grade glioma had a significantly better OS (95% v 80%; P =.052).

CONCLUSION:

Carboplatin, in the schedule used in this study, produced disease stabilization or improvement in a majority of children with progressive low-grade glioma, with manageable toxicity. Improved treatment strategies are particularly required for patients with diencephalic tumors.

• Authors: Sridharan Gururangan, Christina M Cavazos, David Ashley, James E Herndon 2nd, Carol S Bruggers, Albert Moghrabi, Deborah L Scarcella, Melody Watral, Sandra Tourt-Uhlig, David Reardon, Henry S Friedman
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 20 Issue 13 Pg. 2951-8 (Jul 01 2002) ISSN: 0732-183X [Print] United States
• PMID: 12089224 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article)

Chemical References

• Antineoplastic Agents
• Carboplatin

Topics

• Adolescent
• Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
• Brain Neoplasms (drug therapy)
• Carboplatin (administration & dosage, adverse effects, therapeutic use)
• Child
• Child, Preschool
• Disease Progression
• Drug Administration Schedule
• Female
• Glioma (drug therapy)
• Humans
• Infant
• Infusions, Intravenous
• Male
• Neoplasm Staging
• Salvage Therapy
• Survival Analysis
• Time Factors
• Treatment Outcome