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Liposomal cytarabine for central nervous system embryonal tumors in children and young adults

  • Clinical Study – Patient Study
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Abstract

To assess the tolerability and efficacy of liposomal cytarabine (LC), an encapsulated, sustained-release, intrathecal (IT) formulation of cytosine arabinoside, in de novo and relapsed central nervous system (CNS) embryonal tumors in children and young adults. We studied retrospectively all patients less than age 30 at our institution treated consecutively with LC for medulloblastoma (MB), primitive neuroectodermal tumor (PNET), and atypical teratoid rhabdoid tumor (ATRT). Seventeen patients received LC (2 mg/kg up to 50 mg, every 2 weeks to monthly) at diagnosis of high-risk CNS embryonal tumor (2 PNET, 3 ATRT) or relapse of MB (12 MB; 9 had leptomeningeal metastases). Sixteen patients received concurrent systemic chemotherapy. A total of 108 doses were administered (IT 82, intraventricular 26) with a mean of six (range 1–16) treatments per patient. Only three administrations were associated with adverse effects of arachnoiditis or headache. None developed malignant cerebrospinal fluid (CSF) cytology while receiving LC. All the six evaluable patients with malignant CSF cytology and treated with at least two doses cleared their CSF (mean 3 doses, range 1–5). Median overall survival in relapse patients was 9.1 months. Five patients (4 de novo and 1 relapsed) remain alive in complete remission for a median 26.8 months from first LC. Liposomal cytarabine is an easily administered, well-tolerated, and active drug in patients with high-risk embryonal neoplasms. One-third of our cohort remains in remission from otherwise fatal diagnoses. Our findings warrant a phase II trial of LC in newly diagnosed or recurrent CNS embryonal tumors.

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Authors and Affiliations

  1. Department of Neurology, Stanford University Medical Center, Room A343, 300 Pasteur Drive, Stanford, CA, 94305-5235, USA

    Sonia Partap, Patricia A. Murphy & Paul G. Fisher

  2. Department of Pathology, Stanford University, Stanford, CA, USA

    Hannes Vogel

  3. Department of Radiology, Stanford University, Stanford, CA, USA

    Patrick D. Barnes

  4. Department of Neurosurgery, Stanford University, Stanford, CA, USA

    Michael S. B. Edwards & Paul G. Fisher

  5. Department of Pediatrics, Stanford University, Stanford, CA, USA

    Paul G. Fisher

  6. Department of Human Biology, Stanford University, Stanford, CA, USA

    Paul G. Fisher

Authors
  1. Sonia Partap
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  2. Patricia A. Murphy
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  3. Hannes Vogel
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  4. Patrick D. Barnes
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  5. Michael S. B. Edwards
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  6. Paul G. Fisher
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Correspondence to Sonia Partap.

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Partap, S., Murphy, P.A., Vogel, H. et al. Liposomal cytarabine for central nervous system embryonal tumors in children and young adults. J Neurooncol 103, 561–566 (2011). https://doi.org/10.1007/s11060-010-0419-y

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  • DOI: https://doi.org/10.1007/s11060-010-0419-y

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