Abstract
PurposeThe combination of irinotecan, temozolomide and vincristine has been proposed as an effective salvage regimen for some pediatric malignancies. Thus, we sought to evaluate this combination for patients with relapsed and refractory neuroblastoma (NB).Patients and MethodsIn this retrospective study, forty-six patients with relapsed or refractory NB were treated with the combination of vincristine (1.5 mg/m2 i.v. day 1), irinotecan (50 mg/m2/day i.v. days 1–5) and temozolomide (100 mg/m2/day p.o. days 1–5) (VIT) during the period 2011–2019. All toxicities were documented.ResultsA total of 251 cycles (median 6 cycles/patient) were administered. A complete response (CR) was achieved in 5 patients, partial response (PR) in 27 patients, stable disease (SD) in 8 patients, and progression disease (PD) in 6 patients, with an overall objective response rate (CR+PR) of 69.6%. Eighteen patients developed diarrhea with Grade 3 or less. Grade 1-2 hematologic toxicity occurred in 10 patients. Grade 3-4 hematologic toxicity developed in 32 patients. VIT was an effective regimen for different metastatic sites. UGT1A*28 genotyping performed in 7 patients revealed wild type. Diarrhea occurred in 4 of them.ConclusionThe shorter, 5-day VIT regimen is an active and well-tolerated salvage regimen in relapse/refractory NB.
Highlights
Neuroblastoma is the most common extracranial solid tumor in childhood
Five patients were stratified into intermediate-risk group and 41 were categorized into high-risk group at initial diagnosis on the basis of the following factors: stage, age, International Neuroblastoma Pathologic Classification, amplification of the MYCN oncogene within tumor tissue
MYCN amplification occurred in 8 patients and 27 patients were in the absence of MYCN amplification
Summary
Neuroblastoma is the most common extracranial solid tumor in childhood. Most of these patients were sensitive to chemotherapy, the long-term outcome of high-risk patients has remained dismal with 5-year overall survival (OS) rates less than 50%. Salvage therapy could prolong survival in multiply relapsed patients. Patients with relapsed or recurrent neuroblastoma at the Sun Yat-Sen University Cancer Center received chemotherapy comprising vincristine, irinotecan, and temozolomide (VIT therapy) from 2011 as salvage chemotherapy. In this study we VIT in Neuroblastoma retrospectively analyzed the therapeutic effects, and toxicity of VIT in patients with relapsed or refractory neuroblastoma
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
