Gemcitabine based chemotherapy in recurrent or advanced pediatric solid tumors: A phase II study

Abstract

8574 Background: Although rare, cancer is the leading cause of death in children younger than 15 years around the world. Advances have been made in treating these patients over the last three decades by apropiate therapy. This dramatic improvement in outcome has led to the estimation that in the year 2000, one in every 1,000 young adults between the ages 20 and 29 years would have been a survivor of childhood cancer; and this due to the chemotherapy. Methods: There were 11 children: 7 male and 4 female. The inclusion period was since january 2003 until the last patient entried in september 2003. Patients had recurrent or refractory solid tumor; TREATMENT: Gemcitabine alone 800 mg/m2 days 1 and 8 or in combination with cisplatin at 80 mg/m2 day 1. Results: The median age was 7.7 years (2–17) The histopathology was 2 pts with Ewing sarcoma, 2 pts germ cell tumors, 1 pt Wilms tumor, 2 pt rhabdomiosarcoma, 1 pt rethnoblastoma, 1 pt ostheosacoma and 1 pt hepatoblastoma. All patients were previous treated with chemotherapy: 5 pts received VAC (vincristine, adryamicin and cyclophospamide); 3 received ICE (Ifosfamide, cyclophospamide and epirubicin); and 3 pts received: VeIP, VAI and ethoposide- carboplatin. Nine pts received gemcitabine alone and 2 pts received gemcitabine plus cisplatin. There were 1 Partial Response (PR), 3 patients with Stable disease (SD) and 3 with progresión disease (PD).0verall Survival (OS) by Kaplan Meier curves was 66.7% at 6 mo. The current status is: 5 patients alive with tumoral activity and 2 dead patients with tumoral activity. There were 24 courses of chemotherapy. Anemia G3,4 was presented in 2 pt (8.3%); Leucopenia G3,4: 2 pt (8.7%); Neutropenia G3,4: 2 pt (8.3%); thrombocytopenia G3,4 in 3 pt (12.5%). Conclusión: Gemcitabine alone or in combination with cisplatin demostrated some efficacy in patients heavly previous treated with good tolerance, it could be an option for rescue treatment. No significant financial relationships to disclose.