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Etoposide, vincristine, and cyclosporin A with standard‐dose radiation therapy in newly diagnosed diffuse intrinsic brainstem gliomas: A pediatric oncology group phase I study
Author(s) -
Greenberg Mark L.,
Fisher Paul G.,
Freeman Carolyn,
Korones David N.,
Bernstein Mark,
Friedman Henry,
Blaney Susan,
Hershon Linda,
Zhou Tianni,
Chen Zhengjia,
Kretschmar Cynthia
Publication year - 2005
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.20382
Subject(s) - medicine , etoposide , vincristine , regimen , concomitant , glioma , oncology , chemotherapy , cyclophosphamide , cancer research
Background Brainstem gliomas (BSGs) are resistant to all therapy. Based on their imaging characteristics, we postulated that inhibition of P‐glycoprotein (P‐gp) associated with endothelial cells of the blood‐brain barrier might enhance penetration of xenobiotic antineoplastics. Procedure Seven patients were enrolled in a Phase I study of etoposide, continuous infusion cyclosporine A given with and escalating doses of vincristine and concomitant standard‐dose irradiation. Results Six patients were entered at the first level and one at the second. Closure of the study was mandated by dose‐limiting neurotoxicity, consisting of seizures associated with white‐matter changes, and alteration of consciousness with bulbar signs. One patient had tumor necrosis at 6 weeks, suggesting some tumor effect. Median survival for the group was 11 months, and for the patients who completed more than 1 month of therapy it was 11 months. Conclusion This regimen proved excessively toxic. © 2005 Wiley‐Liss, Inc.