Research article summary (published 29 Nov 2009):

Irinotecan and temozolomide for Ewing sarcoma: the Memorial Sloan-Kettering experience.

Full Abstract

BACKGROUND: The prognosis for recurrent/progressive Ewing sarcoma (ES) remains poor. Pre-clinical, adult phase I and II trials have demonstrated the combination of irinotecan and temozolomide to have schedule-dependent synergy and significant antitumor activity. A pediatric phase I trial has shown this regimen to be safe and active in advanced ES. PROCEDURE: We conducted a retrospective chart review to identify patients with recurrent/progressive ES treated with irinotecan [20 mg/m(2)/day x 5(x2)] and temozolomide (100 mg/m(2)/day x 5) in our institution. The best response achieved, time to progression (TTP), and associated toxicities were recorded. RESULTS: Twenty patients received a total of 154 cycles of therapy. Of 19 evaluable patients, there were 5 complete and 7 partial responses (a 63% overall objective response). Median TTP for 20 evaluable patients with recurrent/progressive ES was 8.3 months; for the subset of 14 patients with recurrent ES, it was 16.2 months. Median TTP was better for patients who sustained a 2-year first remission than for those who relapsed < 24 months from diagnosis and for patients with primary localized vs. metastatic disease. Significant toxicities included grade 3 diarrhea (7 cycles), grade 3 colitis (1 cycle), grade 3 pneumonitis in one patient receiving concurrent whole-lung RT, grade 3-4 neutropenia (19 cycles), and grade 3-4 thrombocytopenia (16 cycles). CONCLUSIONS: Irinotecan and temozolomide is a well-tolerated and active regimen for recurrent/progressive ES. Prospective trials are necessary to define the role of this regimen in newly diagnosed ES.

Author information

Author/s: Casey, Denise A (DA); Wexler, Leonard H (LH); Merchant, Melinda S (MS); Chou, Alexander J (AJ); Merola, Pamela R (PR); Price, Anita P (AP); Meyers, Paul A (PA);

Affiliation: Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.

Journal and publication information

Publication Type: Clinical Trial, Phase I; Journal Article

Journal: Pediatric blood & cancer (Pediatr Blood Cancer), published in United States. (Language: eng)

Reference: 2009-Dec; vol 53 (issue 6) : pp 1029-34

Dates: Created 2009/09/16; Completed 2009/10/13;

PMID: 19637327, status: MEDLINE (last retrieval date: 10/13/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent Adult Antineoplastic Agents, Alkylating Antineoplastic Agents, Phytogenic Camptothecin - administration & dosage; analogs & derivatives; toxicity Child Child, Preschool Colitis - chemically induced Dacarbazine - administration & dosage; analogs & derivatives; toxicity Diarrhea - chemically induced Female

Female Humans Male Neutropenia - chemically induced Pneumonia - chemically induced Recurrence Remission Induction Retrospective Studies Sarcoma, Ewing's - complications; drug therapy Thrombocytopenia - chemically induced Young Adult

Associated Chemicals: Antineoplastic Agents, Alkylating (0) ; Antineoplastic Agents, Phytogenic (0) ; irinotecan (100286-90-6) ; Dacarbazine (4342-03-4) ; Camptothecin (7689-03-4) ; temozolomide (85622-93-1)

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