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

  • Clinical-Patient Studies
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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.

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Acknowledgment

Supported by Deutsche Kinderkrebsstiftung.

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Authors and Affiliations

  1. Department of Pediatric Oncology, Krankenhaus der Barmherzigen Brüder, Klinik St. Hedwig, Steinmetzstr. 1-3, 93049, Regensburg, Germany

    Sabine Wagner, Ove Peters & Christin Fels

  2. University of Regensburg, Regensburg, Germany

    Sabine Wagner, Ove Peters, Christin Fels & Johannes E. A. Wolff

  3. Department of Pediatric Oncology, University of Düsseldorf, Moorenstraße 5, 40225, Dusseldorf, Germany

    Gisela Janssen

  4. Department of Pediatric Oncology, HELIOS-Klinikum Berlin-Buch, Wiltbergstr. 50, 13125, Berlin, Germany

    Anne-Kathrin Liebeskind

  5. Department of Pediatric Oncology, Helios Klinikum, Nordhäuser Str.74, 99089, Erfurt, Germany

    Axel Sauerbrey

  6. Department of Pediatric Oncology, University of Dresden, Fetscherstr. 74, 01307, Dresden, Germany

    Meinolf Suttorp

  7. Department of Neuro-Oncology, University of Regensburg, District Medical Center, Universitätsstr. 83, 93053, Regensburg, Germany

    Peter Hau

  8. Department of Pediatrics, Unit 87, The University of Texas M.D. Anderson Cancer Center, 1515 Holcomb Blvd, Houston, TX, 77030, USA

    Johannes E. A. Wolff

Authors
  1. Sabine Wagner
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  2. Ove Peters
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  3. Christin Fels
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  4. Gisela Janssen
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  5. Anne-Kathrin Liebeskind
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  6. Axel Sauerbrey
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  7. Meinolf Suttorp
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  8. Peter Hau
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  9. Johannes E. A. Wolff
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Correspondence to Sabine Wagner.

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Wagner, S., Peters, O., Fels, C. et al. Pegylated-liposomal doxorubicin and oral topotecan in eight children with relapsed high-grade malignant brain tumors. J Neurooncol 86, 175–181 (2008). https://doi.org/10.1007/s11060-007-9444-x

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  • DOI: https://doi.org/10.1007/s11060-007-9444-x

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