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Irinotecan for pediatric solid tumors: the Memorial Sloan-Kettering experience
Maura Cosetti1, Leonard H Wexler, Elizabeth Calleja
1Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Journal of Pediatric Hematology/Oncology
|May 7, 2002
Summary
Irinotecan shows promising activity against relapsed pediatric solid tumors, especially rhabdomyosarcoma. This topoisomerase 1 inhibitor demonstrated efficacy with manageable toxicity in heavily pretreated children.
Area of Science:
- Pediatric Oncology
- Medical Oncology
- Pharmacology
Background:
- Irinotecan is a topoisomerase 1 inhibitor with demonstrated activity in relapsed solid tumors.
- Limited data exists on its use in pediatric populations.
- Preclinical studies and Phase I trials suggest potential efficacy in children.
Purpose of the Study:
- To evaluate the efficacy and toxicity of irinotecan in children with relapsed solid tumors.
- To describe institutional experience with irinotecan in this patient group.
Main Methods:
- A total of 22 heavily pretreated children with multiply relapsed tumors were enrolled.
- Treatment consisted of irinotecan at 20 mg/m2/day for 10 days, repeated in cycles.
- Patients had various relapsed solid tumors including rhabdomyosarcoma, fibrosarcoma, and non-Hodgkin lymphoma.
Main Results:
- Nineteen patients were evaluable for response.
- Objective responses were observed in 4 patients: 2 complete responses and 1 partial response in rhabdomyosarcoma, and 1 partial response in non-Hodgkin lymphoma.
- Stable disease was noted in one patient with fibrosarcoma and one with non-Hodgkin lymphoma.
- Diarrhea was the most frequent toxicity.
Conclusions:
- Irinotecan exhibits promising single-agent activity in pediatric solid tumors, particularly rhabdomyosarcoma.
- The drug demonstrated minimal hematopoietic toxicity, suggesting suitability for further investigation.
- Further evaluation in high-risk newly diagnosed patients, potentially in combination therapy, is warranted.