BACKGROUND: Topotecan is able to cross the blood-brain barrier (BBB) and has been demonstrated to be active in brain metastases from small cell lung cancer (SCLC). PATIENTS AND METHODS: The aim of this study was to evaluate the efficacy and toxicity of topotecan at a dosage of 1.5 mg/m2 for 5 consecutive days every 3 weeks in patients with brain metastases from various neoplasms. RESULTS: Among the 19 patients enrolled, objective responses were observed in 2 out of 3 patients affected by brain metastases from SCLC. Stable disease was observed in 8 more patients (4 breast, 3 non-SCLC and 1 colon). According to the Simon two-step design, patient accrual was stopped because of the low response rate observed in the first 19 patients treated (early stopping rule). The G 3/4 haematological toxicity was severe, with 37% neutropenia, 21% thrombocytopenia and 16% anaemia, respectively. CONCLUSION: Our data do not support the use of topotecan in patients with brain metastases, except for SCLC. In addition, the haematological toxicity prevents the use of this regimen in elderly and poor performance status patients.
BACKGROUND:Topotecan is able to cross the blood-brain barrier (BBB) and has been demonstrated to be active in brain metastases from small cell lung cancer (SCLC). PATIENTS AND METHODS: The aim of this study was to evaluate the efficacy and toxicity of topotecan at a dosage of 1.5 mg/m2 for 5 consecutive days every 3 weeks in patients with brain metastases from various neoplasms. RESULTS: Among the 19 patients enrolled, objective responses were observed in 2 out of 3 patients affected by brain metastases from SCLC. Stable disease was observed in 8 more patients (4 breast, 3 non-SCLC and 1 colon). According to the Simon two-step design, patient accrual was stopped because of the low response rate observed in the first 19 patients treated (early stopping rule). The G 3/4 haematological toxicity was severe, with 37% neutropenia, 21% thrombocytopenia and 16% anaemia, respectively. CONCLUSION: Our data do not support the use of topotecan in patients with brain metastases, except for SCLC. In addition, the haematological toxicity prevents the use of this regimen in elderly and poor performance status patients.
Authors: Priya Kumthekar; Sean A Grimm; Michael J Avram; Virginia Kaklamani; Irene Helenowski; Alfred Rademaker; Mary Cianfrocca; William Gradishar; Jyoti Patel; Mary Mulcahy; Katie McCarthy; Jeffrey J Raizer Journal: J Neurooncol Date: 2013-01-25 Impact factor: 4.130
Authors: Maria Caffo; Valeria Barresi; Gerardo Caruso; Mariano Cutugno; Giuseppe La Fata; Mario Venza; Concetta Alafaci; Francesco Tomasello Journal: Int J Mol Sci Date: 2013-01-22 Impact factor: 5.923
Authors: M J Gil-Gil; M Martinez-Garcia; A Sierra; G Conesa; S Del Barco; S González-Jimenez; S Villà Journal: Clin Transl Oncol Date: 2013-11-26 Impact factor: 3.405
Authors: Andrei Molotkov; Patrick Carberry; Martin A Dolan; Simon Joseph; Sidney Idumonyi; Shunichi Oya; John Castrillon; Elisa E Konofagou; Mikhail Doubrovin; Glenn J Lesser; Francesca Zanderigo; Akiva Mintz Journal: Pharmaceutics Date: 2021-03-18 Impact factor: 6.321