Peter[a]
Journal of Clinical Oncology, Vol 20, Issue 13 (July), 2002: 2951-2958
Phase II Study of Carboplatin in Children With Progressive Low-Grade Gliomas
By Sridharan Gururangan, Christina M. Cavazos, David Ashley, James E. Herndon, II, Carol S. Bruggers, Albert Moghrabi, Deborah L. Scarcella, Melody Watral, Sandra Tourt-Uhlig, David Reardon, Henry S. Friedman
From the Duke University Medical Center, Durham, NC; Primary Children's Medical Center, Salt Lake City, UT; Hospital Sainte-Justine, Montreal, Canada; and Royal Melbourne Children's Hospital, Melbourne, Australia.
Address reprint requests to Sridharan Gururangan, MRCP, The Brain Tumor Center at Duke, Duke University Medical Center, Box 3624, DUMC, Durham, NC 27710;
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/m2 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.
Presented in part at the Thirty-Seventh Annual Meeting of the American Society of Clinical Oncology, San Francisco, CA, May 12-15, 2001.
© 2002 American Society for Clinical Oncology
-----PRESSE------
July 2, 2002
Carboplatin Effective Against Low-Grade Glioma
Scientists from the Duke University Medical Center joined others to report on their assessment of tumor response rate and activity with use of carboplatin in stabilizing the growth of progressive low-grade glioma (J Clin Oncol 20[13]:2951-2958, 2002).
The team studied 81 children between 6 and 204 months of age who were given 560 mg/m² of carboplatin IV every 4 weeks or until their disease progressed, toxicity became unacceptable, or their maximum tumor response was achieved. The subjects received a median of 11 carboplatin cycles; the researchers followed subjects for a median of 55 months following enrollment.
The authors reported that the overall objective response was 28% and the overall disease stabilization rate was 85%. They also noted that the disease progressed in 11 patients on study and 14 after treatment ended. Mostly, myelosuppression was seen as a toxicity; this included grade 3/4 neutropenia in 56 patients and grade 3/4 thrombocytopenia in 40. The 3-year failure-free survival rate was 64%, and overall survival was 84%.
The team noted that patients diagnosed with diencephalic tumors had a worse failure-free survival and overall survival when compared with patients having tumors at other sites. However, significantly better overall survival was seen among patients diagnosed with neurofibromatosis type 1 with progressive low-grade glioma.
On the basis of these results, the researchers concluded that this schedule of carboplatin produced stabilization of disease or improvement in most children with progressive low-grade glioma. Toxicity reported was manageable. The team noted that better treatment strategies are needed for patients found to have diencephalic tumors in particular.
Carboplatin Effective Against Low-Grade Glioma
Scientists from the Duke University Medical Center joined others to report on their assessment of tumor response rate and activity with use of carboplatin in stabilizing the growth of progressive low-grade glioma (J Clin Oncol 20[13]:2951-2958, 2002).
The team studied 81 children between 6 and 204 months of age who were given 560 mg/m² of carboplatin IV every 4 weeks or until their disease progressed, toxicity became unacceptable, or their maximum tumor response was achieved. The subjects received a median of 11 carboplatin cycles; the researchers followed subjects for a median of 55 months following enrollment.
The authors reported that the overall objective response was 28% and the overall disease stabilization rate was 85%. They also noted that the disease progressed in 11 patients on study and 14 after treatment ended. Mostly, myelosuppression was seen as a toxicity; this included grade 3/4 neutropenia in 56 patients and grade 3/4 thrombocytopenia in 40. The 3-year failure-free survival rate was 64%, and overall survival was 84%.
The team noted that patients diagnosed with diencephalic tumors had a worse failure-free survival and overall survival when compared with patients having tumors at other sites. However, significantly better overall survival was seen among patients diagnosed with neurofibromatosis type 1 with progressive low-grade glioma.
On the basis of these results, the researchers concluded that this schedule of carboplatin produced stabilization of disease or improvement in most children with progressive low-grade glioma. Toxicity reported was manageable. The team noted that better treatment strategies are needed for patients found to have diencephalic tumors in particular.