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Journal of Neuro-Oncology

, Volume 86, Issue 2, pp 175–181 | Cite as

Pegylated-liposomal doxorubicin and oral topotecan in eight children with relapsed high-grade malignant brain tumors

  • Sabine Wagner
  • Ove Peters
  • Christin Fels
  • Gisela Janssen
  • Anne-Kathrin Liebeskind
  • Axel Sauerbrey
  • Meinolf Suttorp
  • Peter Hau
  • Johannes E. A. Wolff
Clinical-Patient Studies

Abstract

Background: The combination of topoisomerase I and II chemotherapeutic agents has shown promising preclinical synergistic effects in the treatment of high-grade malignant brain tumors such as high-grade gliomas and choroid plexus carcinomas. To confirm the effectiveness of this treatment combination and determine its possible toxicity, we conducted a retrospective review of the charts of children who received the therapy. Methods: Patients with relapsed malignant brain tumors who were given an individualized treatment of pegylated (PEG)-liposomal doxorubicin and topotecan were included in our study. PEG-liposomal doxorubicin was given intravenously at a dosage of 30–40 mg/m2 over 4 h once every 4 weeks. Additionally, an intravenous formulation of topotecan was given orally twice daily and was increased on an individual basis from a starting dosage of 0.3 mg/m2 per application to a total daily dosage of 0.6 mg/m2. Results: Eight patients were included. The main toxicity (NCI-CTC) after three cycles of the combination therapy was grade IV hematotoxicity (n = 3); grade III hematotoxicity (n = 2), grade III stomatitis (n = 1), grade III infection (n = 2), grade III diarrhea (n = 1); and grade II dermatitis (n = 1). In four patients, stable disease was achieved for 9, 23, more than 24, and more than 48 weeks, respectively. Conclusion: The schedule of PEG-liposomal doxorubicin with 30–40 mg/m2 every 4 weeks in combination with oral topotecan resulted in tumor response, but the toxicity was high. An individualized increasing dose of PEG-liposomal doxorubicin 10–20 mg/m2 every two weeks is now recommended.

Keywords

Liposomal doxorubicin Oral topotecan Children Brain tumors 

Notes

Acknowledgment

Supported by Deutsche Kinderkrebsstiftung.

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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Sabine Wagner
    • 1
    • 2
  • Ove Peters
    • 1
    • 2
  • Christin Fels
    • 1
    • 2
  • Gisela Janssen
    • 3
  • Anne-Kathrin Liebeskind
    • 4
  • Axel Sauerbrey
    • 5
  • Meinolf Suttorp
    • 6
  • Peter Hau
    • 7
  • Johannes E. A. Wolff
    • 2
    • 8
  1. 1.Department of Pediatric OncologyKrankenhaus der Barmherzigen BrüderRegensburgGermany
  2. 2.University of RegensburgRegensburgGermany
  3. 3.Department of Pediatric OncologyUniversity of DüsseldorfDusseldorfGermany
  4. 4.Department of Pediatric OncologyHELIOS-Klinikum Berlin-BuchBerlinGermany
  5. 5.Department of Pediatric OncologyHelios KlinikumErfurtGermany
  6. 6.Department of Pediatric OncologyUniversity of DresdenDresdenGermany
  7. 7.Department of Neuro-OncologyUniversity of Regensburg, District Medical CenterRegensburgGermany
  8. 8.Department of Pediatrics, Unit 87The University of Texas M.D. Anderson Cancer CenterHoustonUSA

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