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Irinotecan therapy in adults with recurrent or progressive malignant glioma.

Publication ,  Journal Article
Friedman, HS; Petros, WP; Friedman, AH; Schaaf, LJ; Kerby, T; Lawyer, J; Parry, M; Houghton, PJ; Lovell, S; Rasheed, K; Cloughsey, T; Rich, J ...
Published in: J Clin Oncol
May 1999

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.

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Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

May 1999

Volume

17

Issue

5

Start / End Page

1516 / 1525

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • Oligodendroglioma
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Irinotecan
  • Humans
  • Glioma
  • Glioblastoma
  • Female
 

Citation

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Friedman, H. S., Petros, W. P., Friedman, A. H., Schaaf, L. J., Kerby, T., Lawyer, J., … Miller, L. L. (1999). Irinotecan therapy in adults with recurrent or progressive malignant glioma. J Clin Oncol, 17(5), 1516–1525. https://doi.org/10.1200/JCO.1999.17.5.1516
Friedman, H. S., W. P. Petros, A. H. Friedman, L. J. Schaaf, T. Kerby, J. Lawyer, M. Parry, et al. “Irinotecan therapy in adults with recurrent or progressive malignant glioma.J Clin Oncol 17, no. 5 (May 1999): 1516–25. https://doi.org/10.1200/JCO.1999.17.5.1516.
Friedman HS, Petros WP, Friedman AH, Schaaf LJ, Kerby T, Lawyer J, et al. Irinotecan therapy in adults with recurrent or progressive malignant glioma. J Clin Oncol. 1999 May;17(5):1516–25.
Friedman, H. S., et al. “Irinotecan therapy in adults with recurrent or progressive malignant glioma.J Clin Oncol, vol. 17, no. 5, May 1999, pp. 1516–25. Pubmed, doi:10.1200/JCO.1999.17.5.1516.
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. Irinotecan therapy in adults with recurrent or progressive malignant glioma. J Clin Oncol. 1999 May;17(5):1516–1525.

Published In

J Clin Oncol

DOI

ISSN

0732-183X

Publication Date

May 1999

Volume

17

Issue

5

Start / End Page

1516 / 1525

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • Oligodendroglioma
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Male
  • Irinotecan
  • Humans
  • Glioma
  • Glioblastoma
  • Female