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Motexafin-gadolinium and involved field radiation therapy for intrinsic pontine glioma of childhood: a children's oncology group phase 2 study.

AbstractPURPOSE:
To evaluate the effects on 1-year event-free survival (EFS) and overall survival (OS) of combining motexafin and gadolinium (MGd), a potent radiosensitizer, with daily fractionated radiation therapy in children with newly diagnosed intrinsic pontine gliomas.
METHODS AND MATERIALS:
Patients with newly diagnosed intrinsic pontine glioma were treated with MGd daily for 5 consecutive days each week, for a total of 30 doses. Patients received a 5- to 10-min intravenous bolus of MGd, 4.4 mg/kg/day, given 2 to 5 h prior to standard dose irradiation. Radiation therapy was administered at a daily dose of 1.8 Gy for 30 treatments over 6 weeks. The total dose was 54 Gy.
RESULTS:
Sixty eligible children received MGd daily, concurrent with 6 weeks of radiation therapy. The estimated 1-year EFS was 18%±5%, and the estimated 1-year OS was 53%±6.5%. The most common grade 3 to 4 toxicities were lymphopenia, transient elevation of liver transaminases, and hypertension.
CONCLUSIONS:
Compared to historical controls, the addition of MGd to a standard 6-week course of radiation did not improve the survival of pediatric patients with newly diagnosed intrinsic pontine gliomas.
AuthorsKristin A Bradley, Tianni Zhou, Rene Y McNall-Knapp, Regina I Jakacki, Adam S Levy, Gilbert Vezina, Ian F Pollack
JournalInternational journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 85 Issue 1 Pg. e55-60 (Jan 01 2013) ISSN: 1879-355X [Electronic] United States
PMID23092726 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, N.I.H., Extramural)
CopyrightCopyright © 2013 Elsevier Inc. All rights reserved.
Chemical References
  • Metalloporphyrins
  • Radiation-Sensitizing Agents
  • motexafin gadolinium
Topics
  • Adolescent
  • Brain Stem Neoplasms (mortality, radiotherapy)
  • Child
  • Child, Preschool
  • Disease-Free Survival
  • Dose Fractionation, Radiation
  • Drug Administration Schedule
  • Female
  • Glioma (mortality, radiotherapy)
  • Humans
  • Hypertension (chemically induced)
  • Infant
  • Infusions, Intravenous
  • Liver (enzymology)
  • Lymphopenia (chemically induced)
  • Male
  • Metalloporphyrins (adverse effects, therapeutic use)
  • Pons
  • Radiation-Sensitizing Agents (adverse effects, therapeutic use)

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