Irinotecan and temozolomide for Ewing sarcoma: The Memorial Sloan-Kettering experience Journal Article
| Authors: | Casey, D. A.; Wexler, L. H.; Merchant, M. S.; Chou, A. J.; Merola, P. R.; Price, A. P.; Meyers, P. A. |
| Article Title: | Irinotecan and temozolomide for Ewing sarcoma: The Memorial Sloan-Kettering experience |
| Abstract: | Background. The prognosis for recurrent/progressive Ewing sarcoma (ES) remains poor. Pre-clinical, adult phase I and II trials have demonstrated the combination of irinotecan and temozolomide to have schedule-dependent synergy and significant antitumor activity. A pediatric phase I trial has shown this regimen to be safe and active in advanced ES. Procedure. We conducted a retrospective chart review to identify patients with recurrent/progressive ES treated with irinotecan [20 mg/m<sup>2</sup>/day x 5(x2)] and temozolomide (100 mg/ m<sup>2</sup>/day x 5) in our institution. The best response achieved, time to progression (TTP), and associated toxicities were recorded. Results. Twenty patients received a total of 154 cycles of therapy. Of 19 evaluable patients, there were 5 complete and 7 partial responses (a 63% overall objective response). Median TTP for 20 evaluable patients with recurrent/progressive ES was 8.3 months; for the subset of 14 patients with recurrent ES, it was 16.2 months. Median TTP was better for patients who sustained a 2-year first remission than for those who relapsed <24 months from diagnosis and for patients with primary localized vs. metastatic disease. Significant toxicities included grade 3 diarrhea (7 cycles), grade 3 colitis (1 cycle), grade 3 pneumonitis in one patient receiving concurrent whole-lung RT, grade 3-4 neutropenia (19 cycles), and grade 3-4 thrombocytopenia (16 cycles). Conclusions. Irinotecan and temozolomide is a well-tolerated and active regimen for recurrent/progressive ES. Prospective trials are necessary to define the role of this regimen in newly diagnosed ES. © 2009 Wiley-Liss, Inc. |
| Keywords: | clinical article; human tissue; treatment response; antibiotic agent; cancer surgery; drug tolerability; neutropenia; doxorubicin; cancer combination chemotherapy; cancer growth; diarrhea; drug dose reduction; multimodality cancer therapy; treatment duration; cancer radiotherapy; temozolomide; recurrent cancer; metastasis; multiple cycle treatment; etoposide; thrombocytopenia; cyclophosphamide; steroid; vincristine; medical record review; retrospective study; ifosfamide; irinotecan; ewing sarcoma; febrile neutropenia; pneumonia; cancer regression; disease severity; cancer relapse; colitis; loperamide; octreotide; bacteremia; clostridium difficile infection; intravenous administration |
| Journal Title: | Pediatric Blood and Cancer |
| Volume: | 53 |
| Issue: | 6 |
| ISSN: | 1545-5009 |
| Publisher: | Wiley Periodicals, Inc |
| Date Published: | 2009-12-01 |
| Start Page: | 1029 |
| End Page: | 1034 |
| Language: | English |
| DOI: | 10.1002/pbc.22206 |
| PROVIDER: | scopus |
| PUBMED: | 19637327 |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 7" - "Export Date: 30 November 2010" - "CODEN: PBCEA" - "Source: Scopus" |
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