Irinotecan therapy in adults with recurrent or progressive malignant glioma.


Journal Article

PURPOSE: To determine the activity, toxicity, and pharmacokinetics of irinotecan (CPT-11, Camptosar; Pharmacia & Upjohn, Kalamazoo, MI) in the treatment of adults with progressive, persistent, or recurrent malignant glioma. PATIENTS AND METHODS: Patients with progressive or recurrent malignant gliomas were enrolled onto this study between October 1996 and August 1997. CPT-11 was given as a 90-minute intravenous (i.v.) infusion at a dose of 125 mg/m2 once weekly for 4 weeks followed by a 2-week rest, which comprised one course. Plasma concentrations of CPT-11 and its metabolites, SN-38 and SN-38 glucuronide (SN-38G), were determined in a subset of patients. RESULTS: All 60 patients who enrolled (36 males and 24 females) were treated with CPT-11 and all were assessable for toxicity, response, and survival. Pharmacokinetic data were available in 32 patients. Nine patients (15%; 95% confidence interval, 6% to 24%) had a confirmed partial response, and 33 patients (55%) achieved stable disease lasting more than two courses (12 weeks). Toxicity observed during the study was limited to infrequent neutropenia, nausea, vomiting, and diarrhea. CPT-11, SN-38, and SN-38G area under the plasma concentration-time curves through infinite time values in these patients were approximately 40%, 25%, and 25%, respectively, of those determined previously in patients with metastatic colorectal cancer not receiving antiepileptics or chronic dexamethasone treatment. CONCLUSION: Response results document that CPT-11, given with a standard starting dose and treatment schedule, has activity in patients with recurrent malignant glioma. However, the low incidence of severe toxicity and low plasma concentrations of CPT-11 and SN-38 achieved in this patient population suggest that concurrent treatment with anticonvulsants and dexamethasone enhances drug clearance.

Full Text

Duke Authors

Cited Authors

  • Friedman, HS; Petros, WP; Friedman, AH; Schaaf, LJ; Kerby, T; Lawyer, J; Parry, M; Houghton, PJ; Lovell, S; Rasheed, K; Cloughsey, T; Stewart, ES; Colvin, OM; Provenzale, JM; McLendon, RE; Bigner, DD; Cokgor, I; Haglund, M; Rich, J; Ashley, D; Malczyn, J; Elfring, GL; Miller, LL

Published Date

  • May 1999

Published In

Volume / Issue

  • 17 / 5

Start / End Page

  • 1516 - 1525

PubMed ID

  • 10334539

Pubmed Central ID

  • 10334539

International Standard Serial Number (ISSN)

  • 0732-183X

Digital Object Identifier (DOI)

  • 10.1200/JCO.1999.17.5.1516


  • eng

Conference Location

  • United States