Temozolomide in malignant gliomas of childhood: a United Kingdom Children's Cancer Study Group and French Society for Pediatric Oncology Intergroup Study

United Kingdom Children's Cancer Study Group and French Society for Pediatric Oncology Intergroup Study, L S Lashford, P Thiesse, A Jouvet, T Jaspan, D Couanet, P D Griffiths, F Doz, J Ironside, K Robson, R Hobson, M Dugan, A D J Pearson, G Vassal, D Frappaz

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSE: To determine the response rate of the malignant gliomas of childhood to an oral, daily schedule of temozolomide.

PATIENTS AND METHODS: A multicenter, phase II evaluation of an oral, daily schedule of temozolomide (200 mg/m(2) on 5 consecutive days) was undertaken in children with relapsed or progressive, biopsy-proven, high-grade glioma (arm A) and progressive, diffuse, intrinsic brainstem glioma (arm B). Evidence of activity was defined by radiologic evidence of a sustained reduction in tumor size on serial magnetic resonance imaging scans.

RESULTS: Fifty-five patients were recruited (34 to arm A and 21 to arm B) and received 215 cycles of chemotherapy. Grade 3/4 thrombocytopenia was the most frequent toxic event (7% of cycles). Prolonged myelosuppression resulted in significant treatment delays and dose reductions (17% and 22% of cycles, respectively). Two toxic deaths were documented and were related to myelosuppression and sepsis in one patient and pneumonia in a second. The overall (best) response rate was 12% for arm A (95% confidence interval [CI], 3 to 28 in the study cohort, and 2 to 31 for eligible patients) and 5% and 6%, respectively, for arm B (95% CI, 0 to 26 in the study cohort, and 0 to 27 for eligible patients). Stabilization of disease was also documented and was most noteworthy for brainstem gliomas, where two patients achieved both radiologic static disease and discontinued steroid medication.

CONCLUSION: Despite moderate toxicity, objective response rates to temozolomide have been low, indicating that temozolomide has minimal activity in the high-grade gliomas of childhood.

Original languageEnglish
Pages (from-to)4684-91
Number of pages8
JournalJournal of Clinical Oncology
Volume20
Issue number24
Publication statusPublished - 15 Dec 2002

Keywords

  • Adolescent
  • Antineoplastic Agents, Alkylating
  • Bone Marrow
  • Brain Neoplasms
  • Child
  • Child, Preschool
  • Dacarbazine
  • Female
  • Glioma
  • Humans
  • Male
  • Thrombocytopenia

Fingerprint

Dive into the research topics of 'Temozolomide in malignant gliomas of childhood: a United Kingdom Children's Cancer Study Group and French Society for Pediatric Oncology Intergroup Study'. Together they form a unique fingerprint.

Cite this