BACKGROUND: The NCIC Clinical Trial Group has an ongoing interest in assessing investigational agents in minimally pretreated patients with malignant glioma. Topotecan is one of the first topoisomerase I inhibitors to enter clinical trials and has shown early evidence of activity in several solid tumors. We have conducted a phase II trial of topotecan in patients with malignant glioma. METHODS: Adults with malignant glioma and recurrent contrast enhancing measurable disease (> or = 2 x 2 cm) were eligible. Topotecan 1.5 mg/m2 i.v. was given daily x five days every three weeks. Response and toxic effects were assessed at the end of each cycle. RESULTS: Thirty-one patients were entered onto the study: fifteen had glioblastoma, 16 anaplastic astrocytoma, all had prior radiation, 15 prior chemotherapy, and all were assessable for response and toxicity. Two patients (6%) responded: one had a complete radiographic response, but died with neutropenic sepsis, and the second had a prolonged partial response (> 97 weeks). Twenty-one patients (68%) had stable disease for five to 86 + weeks (median 19) and eight (26%) had progressive disease after one cycle. Toxicity was primarily hematologic; 18 (58%) had grade 4 neutropenia (< 0.5 x 10(9)/1), usually brief, and three (10%) grade 4 thrombocytopenia (< 25 x 10(9)/1). Twelve of 109 cycles (11%) were given at reduced dose. CONCLUSIONS: Topotecan in this dose and schedule has only modest activity in recurrent glioblastoma and anaplastic astrocytoma.
BACKGROUND: The NCIC Clinical Trial Group has an ongoing interest in assessing investigational agents in minimally pretreated patients with malignant glioma. Topotecan is one of the first topoisomerase I inhibitors to enter clinical trials and has shown early evidence of activity in several solid tumors. We have conducted a phase II trial of topotecan in patients with malignant glioma. METHODS: Adults with malignant glioma and recurrent contrast enhancing measurable disease (> or = 2 x 2 cm) were eligible. Topotecan 1.5 mg/m2 i.v. was given daily x five days every three weeks. Response and toxic effects were assessed at the end of each cycle. RESULTS: Thirty-one patients were entered onto the study: fifteen had glioblastoma, 16 anaplastic astrocytoma, all had prior radiation, 15 prior chemotherapy, and all were assessable for response and toxicity. Two patients (6%) responded: one had a complete radiographic response, but died with neutropenic sepsis, and the second had a prolonged partial response (> 97 weeks). Twenty-one patients (68%) had stable disease for five to 86 + weeks (median 19) and eight (26%) had progressive disease after one cycle. Toxicity was primarily hematologic; 18 (58%) had grade 4 neutropenia (< 0.5 x 10(9)/1), usually brief, and three (10%) grade 4 thrombocytopenia (< 25 x 10(9)/1). Twelve of 109 cycles (11%) were given at reduced dose. CONCLUSIONS:Topotecan in this dose and schedule has only modest activity in recurrent glioblastoma and anaplastic astrocytoma.
Authors: Laura P Serwer; Charles O Noble; Karine Michaud; Daryl C Drummond; Dmitri B Kirpotin; Tomoko Ozawa; Michael D Prados; John W Park; C David James Journal: Neuro Oncol Date: 2011-09-27 Impact factor: 12.300
Authors: R P Kadota; C F Stewart; M Horn; J F Kuttesch; P C Burger; J L Kepner; L E Kun; H S Friedman; R L Heideman Journal: J Neurooncol Date: 1999-05 Impact factor: 4.130
Authors: J Pollina; R J Plunkett; M J Ciesielski; A Lis; T A Barone; S J Greenberg; R A Fenstermaker Journal: J Neurooncol Date: 1998-09 Impact factor: 4.130
Authors: Ingeborg Fischer; Clare H Cunliffe; Robert J Bollo; Shahzad Raza; David Monoky; Luis Chiriboga; Erik C Parker; John G Golfinos; Patrick J Kelly; Edmond A Knopp; Michael L Gruber; David Zagzag; Ashwatha Narayana Journal: Neuro Oncol Date: 2008-08-12 Impact factor: 12.300