Literature DB >> 17668866

A Phase 1 and pharmacokinetic clinical trial of paclitaxel for the treatment of refractory leukemia in children: a Children's Oncology Group study.

Terzah M Horton1, Matthew M Ames, Joel M Reid, Mark D Krailo, Thomas Pendergrass, Revonda Mosher, Gregory H Reaman, Nita L Seibel.   

Abstract

BACKGROUND: This report summarizes a phase 1 study conducted by the Children's Cancer Group (CCG) to determine the maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), pharmacokinetics, and anti-leukemia activity of paclitaxel in children with advanced stage leukemias. PROCEDURE: This study examined two dose escalation schedules of intravenous paclitaxel. Doses ranged from 250 to 500 mg/m(2) every 21 days in schedule A and 105 to 200 mg/m(2) weekly x 3 every 28 days in schedule B. Serial plasma samples for pharmacokinetic studies were obtained after the first paclitaxel dose.
RESULTS: Sixty-three patients (median 10 years) with refractory or relapsed leukemia (ALL) (n = 39), acute myeloid leukemia (AML) (n = 19), biphenotypic (n = 4), and JCML (n = 1)) were enrolled. The DLTs in schedule A were grade 4 hypertension and hyperbilirubinemia with an MTD of 430 mg/m(2) every 21 days. The DLTs in schedule B were coagulopathy, hyperkalemia, hyperbilirubinemia, elevated SGOT (n = 1, 125 mg/m(2)), peripheral neuropathy (n = 1, 200 mg/m(2)), and typhlitis (n = 1, 200 mg/m(2)) with an MTD of 182 mg/m(2) weekly x 3 every 28 days. Among 54 evaluable patients, there was one complete response (CR), three partial responses (PR), and five patients with stable disease (SD). The mean terminal elimination half-life was 9.5 +/- 3.4 hr and the mean plasma clearance was 23 +/- 11 L/hr/m(2).
CONCLUSIONS: Paclitaxel was tolerated at 430 mg/m(2) every 21 days and at 182 mg/m(2)/dose weekly x 3 every 28 days in pediatric patients. The objective response rate across all dose levels and schedules was <10%. (c) 2008 Wiley-Liss, Inc.

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Year:  2008        PMID: 17668866      PMCID: PMC6777707          DOI: 10.1002/pbc.21310

Source DB:  PubMed          Journal:  Pediatr Blood Cancer        ISSN: 1545-5009            Impact factor:   3.167


  16 in total

1.  A role for paclitaxel in the combination chemotherapy of acute myeloblastic leukaemia: preclinical cell culture studies.

Authors:  J E Curtis; S Minkin; M D Minden; E A McCulloch
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2.  Phase I study of taxol in refractory acute myelogenous leukemias using a weekly schedule.

Authors:  R Munker; H Kantarjian; S O'Brien; M Keating; M Andreeff; E H Estey
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Review 3.  The taxanes: an update.

Authors:  J Crown; M O'Leary
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4.  Phase I targeted systemic exposure study of paclitaxel in children with refractory acute leukemias.

Authors:  M H Woo; M V Relling; D S Sonnichsen; G K Rivera; C B Pratt; C H Pui; W E Evans; A S Pappo
Journal:  Clin Cancer Res       Date:  1999-03       Impact factor: 12.531

5.  Phase 1 study of Paclitaxel administered twice weekly to children with refractory solid tumors: a pediatric oncology group study.

Authors:  Robert J Hayashi; Susan Blaney; Jim Sullivan; Steve Weitman; Teresa Vietti; Mark L Bernstein
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6.  Taxol induces internucleosomal DNA fragmentation associated with programmed cell death in human myeloid leukemia cells.

Authors:  K Bhalla; A M Ibrado; E Tourkina; C Tang; M E Mahoney; Y Huang
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Review 7.  Update on the antitumor activity of paclitaxel in clinical trials.

Authors:  E K Rowinsky
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8.  Phase II study of single agent paclitaxel in adult patients with relapsed acute lymphocytic leukemia.

Authors:  Dawn E Colburn; Deborah A Thomas; Francis J Giles
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9.  Phase I trial of paclitaxel in children with refractory solid tumors: a Pediatric Oncology Group Study.

Authors:  C A Hurwitz; M V Relling; S D Weitman; Y Ravindranath; T J Vietti; D R Strother; A H Ragab; C B Pratt
Journal:  J Clin Oncol       Date:  1993-12       Impact factor: 44.544

10.  Saturable pharmacokinetics and paclitaxel pharmacodynamics in children with solid tumors.

Authors:  D S Sonnichsen; C A Hurwitz; C B Pratt; J J Shuster; M V Relling
Journal:  J Clin Oncol       Date:  1994-03       Impact factor: 44.544

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4.  Phase I study of paclitaxel with standard dose ifosfamide in children with refractory solid tumors: a Pediatric Oncology Group study (POG 9376).

Authors:  James I Geller; Donna Wall; John Perentesis; Susan M Blaney; Mark Bernstein
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Review 6.  Prioritization of Novel Agents for Patients with Rhabdomyosarcoma: A Report from the Children's Oncology Group (COG) New Agents for Rhabdomyosarcoma Task Force.

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  6 in total

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