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Resistant and relapsing neuroblastoma: improved response rate with a new multiagent regimen (OC-HDP) including
Insights
The OC-HDP regimen, combining vincristine, cyclophosphamide, and high-dose cisplatinum, shows promise for treating advanced neuroblastoma. This treatment led to good responses and long-term remission in children with resistant or relapsed disease.
Area of Science:
- Pediatric Oncology
- Medical Chemotherapy
Background:
- Neuroblastoma is a common childhood cancer.
- Advanced or relapsed neuroblastoma presents significant treatment challenges.
Purpose of the Study:
- To evaluate the efficacy and toxicity of a novel three-drug regimen (OC-HDP) for treating advanced neuroblastoma in children.
- To assess the response rates and long-term outcomes in patients with resistant or relapsed neuroblastoma.
Main Methods:
- Eleven children (6 months to 6 years) with resistant or relapsed neuroblastoma received the OC-HDP regimen.
- The regimen included vincristine, cyclophosphamide, and cisplatinum (200 mg/m2 over 5 days).
- Patient response, remission status, and toxicity were closely monitored.
Main Results:
- Nine of eleven patients achieved a good response to the OC-HDP treatment.
- Six patients remain in continuous complete remission 11-23 months post-diagnosis.
- Toxicity was moderate, with no severe myelotoxicity or nephrotoxicity observed; some high-frequency hearing loss occurred.
Conclusions:
- The OC-HDP regimen demonstrates significant efficacy in treating advanced neuroblastoma.
- This regimen is a potential first-line treatment option for pediatric patients with advanced neuroblastoma.
- Further investigation into the OC-HDP regimen's long-term benefits and safety profile is warranted.
Abstract:
From September 1984 to July 1985, 11 children from 6 months to 6 years of age were treated with a three-drug regimen (OC-HDP), including vincristine, cyclophosphamide, and cisplatinum 200 mg/m2 given as five dose-fractions over 5 days. Nine had resistant and two relapsed neuroblastoma. Nine children had previously been treated with cisplatinum at conventional doses; nine had not received cyclophosphamide and ten had not received vincristine. Nine of eleven patients had a good response to treatment; six are presently alive in continuous complete remission 11-23 months (median 13 months) after diagnosis. Toxicity was moderate: no child showed either severe myelotoxicity or clinical or laboratory evidence of nephrotoxicity. No child had clinically significant ototoxicity. In six children audiometry showed hearing loss for high frequencies after the third cycle of treatment. It is concluded that OC-HDP regimen could be considered as a first-line treatment for advanced neuroblastoma.