A Phase I Study of Irinotecan in Pediatric Patients: A Pediatric Oncology Group Study1
- Susan Blaney2,
- Stacey L. Berg,
- Charles Pratt,
- Steve Weitman,
- Jim Sullivan,
- Lori Luchtman-Jones and
- Mark Bernstein
- Texas Children’s Cancer Center/Baylor College of Medicine, Houston, Texas 77030 [S. B., S. L. B.]; St. Jude Children’s Research Hospital, Memphis, Tennessee 38105 [C. P.]; University of Texas, San Antonio, Texas 78284-7810 [S. W.]; Pediatric Oncology Group Statistical Office, Gainesville, Florida 32601 [J. S.]; Washington University Medical Center, St. Louis, Missouri 63110 [L. L-J.]; and University of Montreal, Montreal H3T 1C5, Quebec, Canada [M. B.]
Abstract
A Phase I trial of irinotecan was performed to determine the maximum tolerated dose (MTD), the dose-limiting toxicities (DLTs), and the incidence and severity of other toxicities in children with refractory solid tumors. Thirty-five children received 146 courses of irinotecan administered as a 60-min i.v. infusion, daily for 5 days, every 21 days, after premedication with dexamethasone and ondansetron. Doses ranged from 30 mg/m2 to 65 mg/m2. An MTD was defined in heavily pretreated and less-heavily pretreated (i.e., two prior chemotherapy regimens, no prior bone marrow transplantation, and no radiation to the spine, skull, ribs, or pelvic bones) patients. Myelosuppression was the primary DLT in heavily pretreated patients, and diarrhea was the DLT in less-heavily pretreated patients. The MTD in the heavily pretreated patient group was 39 mg/m2, and the MTD in the less-heavily pretreated patients was 50 mg/m2. Non-dose-limiting diarrhea that was well controlled and of brief duration was observed in approximately 75% of patients. A partial response was observed in one patient with neuroblastoma, and in one patient with hepatocellular carcinoma. Stable disease (4–20 cycles) was observed in seven patients with a variety of malignancies including neuroblastoma, pineoblastoma, glioblastoma, brainstem glioma, osteosarcoma, hepatoblastoma, and a central nervous system rhabdoid tumor. In conclusion, the recommended Phase II dose of irinotecan administered as a 60-min i.v. infusion daily for 5 days, every 21 days, is 39 mg/m2 in heavily treated and 50 mg/m2 in less-heavily treated children with solid tumors.
Footnotes
-
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
-
↵1 Supported in part by Grant U01CA57745 from the Cancer Therapy Evaluation Programs Division Cancer Treatment/National Cancer Institute, Bethesda, MD and Grant MO1RR00188, General Clinical Research Center, NCRR, NIH, Bethesda, MD.
-
↵2 To whom requests for reprints should be addressed, at Texas Children’s Cancer Center, 6621 Fannin Street, MC 3-3320, Houston, TX 77030. Phone: (713) 770-4586; Fax: (713) 770-4039; E-mail: sblaney{at}txccc.org
-
↵3 The abbreviations used are: CNS, central nervous system; PR, partial response; MTD, maximum tolerated dose; DLT, dose-limiting toxicity; PD, progressive disease.
-
- Accepted October 5, 1900.
- Received July 18, 1900.
- Revision received September 30, 1900.
