Jörg Thomas Hartmann1, R D Issels2, K San Nicolo3, V Grünwald4, B Hertenstein5, E Papesch6, S Krause3, I Sturm7. 1. Clinic for Internal Medicine II, Hematology, Oncology, Immunology, Catholic Hospital Consortium, Franziskus Hospital Bielefeld, Kiskerstrasse 26, Bielefeld, 33615, Germany. joerg.hartmann@franziskus.de. 2. Department of Hematology and Oncology, University of Munich Medical Center, München, Germany. 3. Department of Hematology and Medical Oncology, University Hospital of Erlangen, Erlangen, Germany. 4. Department of Hematology, Hemostaseology, Oncology, and Stem Sell Transplantation, Medical University of Hannover, Hannover, Germany. 5. Department of Hematology and Oncology, Medical Center of Bremen-Mitte gGmbH, Bremen, Germany. 6. Department of Hematology, Medical Oncology and Pneumonology, University Hospital of Mainz, Mainz, Germany. 7. Department of Hematology, Oncology and Tumor Immunology, Charité - University Hospital Berlin, Campus Virchow-Klinikum, Berlin, Germany.
Abstract
BACKGROUND: To assess the efficacy and safety of topotecan and cyclophosphamide (TC) in adult patients with pediatric-type sarcoma subtypes who failed induction chemotherapy. PATIENTS AND METHODS: Patients with pediatric sarcoma subtypes, refractory to or relapsed after at least one prior induction chemotherapy, inoperable, ECOG PS 0-2, with measurable, progressive disease (PD), adequate organ functions, who have been treated with TC combination were retrospectively analysed within the AIO and SAREZ/BMBF network. RESULTS: Thirty-nine patients, median age 28 years (18-58), 14 females, 25 males, have been identified. All patients had received induction treatment according to (inter)national study protocols. Second-line TC was applied in 33 patients (≥3rd-line in 6 patients). Twenty-three patients had refractory disease (evidence of PD during induction chemotherapy); 8 patients experienced an early relapse within 6 months as well as 8 patients after more than 24 months (late relapse). A median of 3 cycles (range, 1-6) had been applied and antitumor activity was: CR 2.6 %, PR 7.9 %, and disease stabilisation (SD) 26.3 %. PR lasted 32.8 months and median duration in patients with SD was 5 months (range, 2.0-14.7). The 3/6-months progression-free rates were 43.2 and 18.9 %. CONCLUSIONS: Limited activity was seen in adult pts with refractory or relapsed pediatric-type sarcomas with the regimen which has proven activity in pediatric patients. Adults with refractory small cell sarcoma appear to have a similar dismal outcome as seen in pts with common adult-type histologies; however, a subset of patients has achieved long-lasting remissions on TC resulting in long-term survival.
BACKGROUND: To assess the efficacy and safety of topotecan and cyclophosphamide (TC) in adult patients with pediatric-type sarcoma subtypes who failed induction chemotherapy. PATIENTS AND METHODS: Patients with pediatric sarcoma subtypes, refractory to or relapsed after at least one prior induction chemotherapy, inoperable, ECOG PS 0-2, with measurable, progressive disease (PD), adequate organ functions, who have been treated with TC combination were retrospectively analysed within the AIO and SAREZ/BMBF network. RESULTS: Thirty-nine patients, median age 28 years (18-58), 14 females, 25 males, have been identified. All patients had received induction treatment according to (inter)national study protocols. Second-line TC was applied in 33 patients (≥3rd-line in 6 patients). Twenty-three patients had refractory disease (evidence of PD during induction chemotherapy); 8 patients experienced an early relapse within 6 months as well as 8 patients after more than 24 months (late relapse). A median of 3 cycles (range, 1-6) had been applied and antitumor activity was: CR 2.6 %, PR 7.9 %, and disease stabilisation (SD) 26.3 %. PR lasted 32.8 months and median duration in patients with SD was 5 months (range, 2.0-14.7). The 3/6-months progression-free rates were 43.2 and 18.9 %. CONCLUSIONS: Limited activity was seen in adult pts with refractory or relapsed pediatric-type sarcomas with the regimen which has proven activity in pediatric patients. Adults with refractory small cell sarcoma appear to have a similar dismal outcome as seen in pts with common adult-type histologies; however, a subset of patients has achieved long-lasting remissions on TC resulting in long-term survival.
Authors: Douglas S Hawkins; Scott Bradfield; James A Whitlock; Mark Krailo; Janet Franklin; Susan M Blaney; Peter C Adamson; Gregory Reaman Journal: Pediatr Blood Cancer Date: 2006-11 Impact factor: 3.167
Authors: Palma Dileo; Jeffrey A Morgan; David Zahrieh; Jayesh Desai; Jeanine M Salesi; David C Harmon; M Travis Quigley; Kathleen Polson; George D Demetri; Suzanne George Journal: Cancer Date: 2007-05-01 Impact factor: 6.860
Authors: C Meazza; M Casanova; E Zaffignani; R Luksch; M Podda; F Favini; S Catania; V Biassoni; C Morosi; A Ferrari Journal: Med Oncol Date: 2008-08-05 Impact factor: 3.064
Authors: Rashmi Chugh; J Kyle Wathen; Robert G Maki; Robert S Benjamin; Shreyaskumar R Patel; Paul A Meyers; Paul A Myers; Dennis A Priebat; Denise K Reinke; Dafydd G Thomas; Mary L Keohan; Brian L Samuels; Laurence H Baker Journal: J Clin Oncol Date: 2009-05-18 Impact factor: 44.544
Authors: George D Demetri; Sant P Chawla; Margaret von Mehren; Paul Ritch; Laurence H Baker; Jean Y Blay; Kenneth R Hande; Mary L Keohan; Brian L Samuels; Scott Schuetze; Claudia Lebedinsky; Yusri A Elsayed; Miguel A Izquierdo; Javier Gómez; Youn C Park; Axel Le Cesne Journal: J Clin Oncol Date: 2009-08-03 Impact factor: 44.544
Authors: Robert G Maki; J Kyle Wathen; Shreyaskumar R Patel; Dennis A Priebat; Scott H Okuno; Brian Samuels; Michael Fanucchi; David C Harmon; Scott M Schuetze; Denise Reinke; Peter F Thall; Robert S Benjamin; Laurence H Baker; Martee L Hensley Journal: J Clin Oncol Date: 2007-07-01 Impact factor: 44.544
Authors: J T Hartmann; K Oechsle; J Huober; A Jakob; M Azemar; M Horger; L Kanz; C Bokemeyer Journal: Invest New Drugs Date: 2006-05 Impact factor: 3.651
Authors: P Blanchette; D Hogg; P Ferguson; J S Wunder; C Swallow; R Gladdy; P Chung; B O'Sullivan; M E Blackstein; C Catton; A A Gupta Journal: Sarcoma Date: 2012-07-18