Difference between revisions of "Low-grade glioma, pediatric"
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Warner-admin (talk | contribs) m (Text replacement - "https://www.ejcancer.com/article/S0959-8049(17)30921-8" to "https://doi.org/10.1016/j.ejca.2017.04.019") |
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{{TOC limit|limit=3}} | {{TOC limit|limit=3}} | ||
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=Adjuvant therapy= | =Adjuvant therapy= | ||
==Carboplatin & Vincristine {{#subobject:056d2c|Regimen=1}}== | ==Carboplatin & Vincristine {{#subobject:056d2c|Regimen=1}}== | ||
| − | |||
CV: '''<u>C</u>'''arboplatin & '''<u>V</u>'''incristine | CV: '''<u>C</u>'''arboplatin & '''<u>V</u>'''incristine | ||
<br>VC: '''<u>V</u>'''incristine & '''<u>C</u>'''arboplatin | <br>VC: '''<u>V</u>'''incristine & '''<u>C</u>'''arboplatin | ||
| + | <div class="toccolours" style="background-color:#eeeeee"> | ||
===Regimen variant #1, 175/1.5 (capped vincristine) {{#subobject:caa541|Variant=1}}=== | ===Regimen variant #1, 175/1.5 (capped vincristine) {{#subobject:caa541|Variant=1}}=== | ||
{| class="wikitable sortable" style="width: 100%; text-align:center;" | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
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|} | |} | ||
| − | ''Note | + | ''Note: The course begins on day 0.'' |
| + | <div class="toccolours" style="background-color:#cbd5e8"> | ||
====Preceding treatment==== | ====Preceding treatment==== | ||
*[[Surgery#CNS_cancer_surgery|Biopsy or incomplete resection]] | *[[Surgery#CNS_cancer_surgery|Biopsy or incomplete resection]] | ||
| + | </div> | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
*[[Carboplatin (Paraplatin)]] 175 mg/m<sup>2</sup> IV once per day on days 0, 7, 14, 21, 42, 49, 56, 63 | *[[Carboplatin (Paraplatin)]] 175 mg/m<sup>2</sup> IV once per day on days 0, 7, 14, 21, 42, 49, 56, 63 | ||
*[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 0, 7, 14, 21, 28, 35, 42, 49, 56, 63 | *[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 0, 7, 14, 21, 28, 35, 42, 49, 56, 63 | ||
| − | |||
'''10-week course''' | '''10-week course''' | ||
| − | + | </div> | |
| + | <div class="toccolours" style="background-color:#cbd5e7"> | ||
====Subsequent treatment==== | ====Subsequent treatment==== | ||
*[[#Carboplatin_.26_Vincristine_88|CV]] maintenance | *[[#Carboplatin_.26_Vincristine_88|CV]] maintenance | ||
| − | + | </div></div><br> | |
| + | <div class="toccolours" style="background-color:#eeeeee"> | ||
===Regimen variant #2, 550/1.5 (uncapped vincristine) {{#subobject:31a2e6|Variant=1}}=== | ===Regimen variant #2, 550/1.5 (uncapped vincristine) {{#subobject:31a2e6|Variant=1}}=== | ||
{| class="wikitable sortable" style="width: 100%; text-align:center;" | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
| Line 65: | Line 68: | ||
|- | |- | ||
|} | |} | ||
| + | <div class="toccolours" style="background-color:#cbd5e8"> | ||
====Preceding treatment==== | ====Preceding treatment==== | ||
*[[Surgery#CNS_cancer_surgery|Biopsy or incomplete resection]] | *[[Surgery#CNS_cancer_surgery|Biopsy or incomplete resection]] | ||
| + | </div> | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
*[[Carboplatin (Paraplatin)]] 550 mg/m<sup>2</sup> IV over 60 minutes once on day 1 | *[[Carboplatin (Paraplatin)]] 550 mg/m<sup>2</sup> IV over 60 minutes once on day 1 | ||
| Line 72: | Line 78: | ||
**Cycles 1 to 4: 1.5 mg/m<sup>2</sup> IV once per day on days 1, 8, 15 | **Cycles 1 to 4: 1.5 mg/m<sup>2</sup> IV once per day on days 1, 8, 15 | ||
**Cycles 5 to 7: 1.5 mg/m<sup>2</sup> IV once on day 1 | **Cycles 5 to 7: 1.5 mg/m<sup>2</sup> IV once on day 1 | ||
| − | |||
'''21-day cycle for 4 cycles, then 28-day cycle for 3 cycles''' | '''21-day cycle for 4 cycles, then 28-day cycle for 3 cycles''' | ||
| − | + | </div> | |
| + | <div class="toccolours" style="background-color:#cbd5e7"> | ||
====Subsequent treatment==== | ====Subsequent treatment==== | ||
*[[#Carboplatin_.26_Vincristine_88|CV]] consolidation | *[[#Carboplatin_.26_Vincristine_88|CV]] consolidation | ||
| − | + | </div></div> | |
===References=== | ===References=== | ||
# Packer RJ, Lange B, Ater J, Nicholson HS, Allen J, Walker R, Prados M, Jakacki R, Reaman G, Needles MN, Phillips PC, Ryan J, Boyett JM, Geyer R, Finlay J. Carboplatin and vincristine for recurrent and newly diagnosed low-grade gliomas of childhood. J Clin Oncol. 1993 May;11(5):850-6. [https://doi.org/10.1200/JCO.1993.11.5.850 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/8487049 PubMed] | # Packer RJ, Lange B, Ater J, Nicholson HS, Allen J, Walker R, Prados M, Jakacki R, Reaman G, Needles MN, Phillips PC, Ryan J, Boyett JM, Geyer R, Finlay J. Carboplatin and vincristine for recurrent and newly diagnosed low-grade gliomas of childhood. J Clin Oncol. 1993 May;11(5):850-6. [https://doi.org/10.1200/JCO.1993.11.5.850 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/8487049 PubMed] | ||
# '''COG A9952:''' Ater JL, Zhou T, Holmes E, Mazewski CM, Booth TN, Freyer DR, Lazarus KH, Packer RJ, Prados M, Sposto R, Vezina G, Wisoff JH, Pollack IF. Randomized study of two chemotherapy regimens for treatment of low-grade glioma in young children: a report from the Children's Oncology Group. J Clin Oncol. 2012 Jul 20;30(21):2641-7. Epub 2012 Jun 4. [https://doi.org/10.1200/JCO.2011.36.6054 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3413276/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/22665535 PubMed] NCT00002944 | # '''COG A9952:''' Ater JL, Zhou T, Holmes E, Mazewski CM, Booth TN, Freyer DR, Lazarus KH, Packer RJ, Prados M, Sposto R, Vezina G, Wisoff JH, Pollack IF. Randomized study of two chemotherapy regimens for treatment of low-grade glioma in young children: a report from the Children's Oncology Group. J Clin Oncol. 2012 Jul 20;30(21):2641-7. Epub 2012 Jun 4. [https://doi.org/10.1200/JCO.2011.36.6054 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3413276/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/22665535 PubMed] NCT00002944 | ||
# '''SIOP-LGG 2004:''' Gnekow AK, Walker DA, Kandels D, Picton S, Perilongo G, Grill J, Stokland T, Sandstrom PE, Warmuth-Metz M, Pietsch T, Giangaspero F, Schmidt R, Faldum A, Kilmartin D, De Paoli A, De Salvo GL; of the Low Grade Glioma Consortium and the participating centers. A European randomised controlled trial of the addition of etoposide to standard vincristine and carboplatin induction as part of an 18-month treatment programme for childhood (≤16 years) low grade glioma - a final report. Eur J Cancer. 2017 Aug;81:206-225. Epub 2017 Jun 22. Erratum in: Eur J Cancer. 2017 Dec 13;:. [https://doi.org/10.1016/j.ejca.2017.04.019 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5517338/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/28649001 PubMed] | # '''SIOP-LGG 2004:''' Gnekow AK, Walker DA, Kandels D, Picton S, Perilongo G, Grill J, Stokland T, Sandstrom PE, Warmuth-Metz M, Pietsch T, Giangaspero F, Schmidt R, Faldum A, Kilmartin D, De Paoli A, De Salvo GL; of the Low Grade Glioma Consortium and the participating centers. A European randomised controlled trial of the addition of etoposide to standard vincristine and carboplatin induction as part of an 18-month treatment programme for childhood (≤16 years) low grade glioma - a final report. Eur J Cancer. 2017 Aug;81:206-225. Epub 2017 Jun 22. Erratum in: Eur J Cancer. 2017 Dec 13;:. [https://doi.org/10.1016/j.ejca.2017.04.019 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5517338/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/28649001 PubMed] | ||
| − | |||
=Recurrent or progressive, non-curative therapy= | =Recurrent or progressive, non-curative therapy= | ||
==Cisplatin & Etoposide (EP) {{#subobject:3a5f3f|Regimen=1}}== | ==Cisplatin & Etoposide (EP) {{#subobject:3a5f3f|Regimen=1}}== | ||
| − | + | <div class="toccolours" style="background-color:#eeeeee"> | |
===Regimen {{#subobject:55de5f|Variant=1}}=== | ===Regimen {{#subobject:55de5f|Variant=1}}=== | ||
{| class="wikitable" style="width: 40%; text-align:center;" | {| class="wikitable" style="width: 40%; text-align:center;" | ||
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''Note: In children less than 1 year old or less than 10 kg, "doses were adjusted to their weight"--reference does not say exactly how doses are adjusted.'' | ''Note: In children less than 1 year old or less than 10 kg, "doses were adjusted to their weight"--reference does not say exactly how doses are adjusted.'' | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
*[[Cisplatin (Platinol)]] 25 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 3, '''given first''' | *[[Cisplatin (Platinol)]] 25 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 3, '''given first''' | ||
*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 to 3, '''given second''' | *[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 to 3, '''given second''' | ||
| − | |||
====Supportive therapy==== | ====Supportive therapy==== | ||
*Hydration for 2 hours before chemotherapy, and for 2 hours after chemotherapy | *Hydration for 2 hours before chemotherapy, and for 2 hours after chemotherapy | ||
| − | |||
'''28-day cycle for 4 cycles, then 35-day cycle for 3 cycles, then 42-day cycle for 3 cycles''' | '''28-day cycle for 4 cycles, then 35-day cycle for 3 cycles, then 42-day cycle for 3 cycles''' | ||
| − | + | </div></div> | |
===References=== | ===References=== | ||
# Massimino M, Spreafico F, Riva D, Biassoni V, Poggi G, Solero C, Gandola L, Genitori L, Modena P, Simonetti F, Potepan P, Casanova M, Meazza C, Clerici CA, Catania S, Sardi I, Giangaspero F. A lower-dose, lower-toxicity cisplatin-etoposide regimen for childhood progressive low-grade glioma. J Neurooncol. 2010 Oct;100(1):65-71. Epub 2010 Feb 12. [https://doi.org/10.1007/s11060-010-0136-6 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/20151174 PubMed] | # Massimino M, Spreafico F, Riva D, Biassoni V, Poggi G, Solero C, Gandola L, Genitori L, Modena P, Simonetti F, Potepan P, Casanova M, Meazza C, Clerici CA, Catania S, Sardi I, Giangaspero F. A lower-dose, lower-toxicity cisplatin-etoposide regimen for childhood progressive low-grade glioma. J Neurooncol. 2010 Oct;100(1):65-71. Epub 2010 Feb 12. [https://doi.org/10.1007/s11060-010-0136-6 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/20151174 PubMed] | ||
| − | |||
==Temozolomide monotherapy {{#subobject:7b66b|Regimen=1}}== | ==Temozolomide monotherapy {{#subobject:7b66b|Regimen=1}}== | ||
| − | + | <div class="toccolours" style="background-color:#eeeeee"> | |
===Regimen variant #1 {{#subobject:4fe4rl|Variant=1}}=== | ===Regimen variant #1 {{#subobject:4fe4rl|Variant=1}}=== | ||
{| class="wikitable sortable" style="width: 60%; text-align:center;" | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
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|} | |} | ||
''Note: This dosing is for patients who previously received craniospinal irradiation (CSI).'' | ''Note: This dosing is for patients who previously received craniospinal irradiation (CSI).'' | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
*[[Temozolomide (Temodar)]] 180 mg/m<sup>2</sup> PO once per day on days 1 to 5 | *[[Temozolomide (Temodar)]] 180 mg/m<sup>2</sup> PO once per day on days 1 to 5 | ||
| − | |||
'''28-day cycle for 11 cycles''' | '''28-day cycle for 11 cycles''' | ||
| − | + | </div></div><br> | |
| + | <div class="toccolours" style="background-color:#eeeeee"> | ||
===Regimen variant #2 {{#subobject:4fe632|Variant=1}}=== | ===Regimen variant #2 {{#subobject:4fe632|Variant=1}}=== | ||
{| class="wikitable sortable" style="width: 60%; text-align:center;" | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
| Line 138: | Line 142: | ||
|- | |- | ||
|} | |} | ||
| + | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
*[[Temozolomide (Temodar)]] 200 mg/m<sup>2</sup> PO once per day on days 1 to 5 | *[[Temozolomide (Temodar)]] 200 mg/m<sup>2</sup> PO once per day on days 1 to 5 | ||
| − | |||
'''28-day cycle for 11 cycles''' | '''28-day cycle for 11 cycles''' | ||
| + | </div></div> | ||
===References=== | ===References=== | ||
# Nicholson HS, Kretschmar CS, Krailo M, Bernstein M, Kadota R, Fort D, Friedman H, Harris MB, Tedeschi-Blok N, Mazewski C, Sato J, Reaman GH; Children's Oncology Group. Phase 2 study of temozolomide in children and adolescents with recurrent central nervous system tumors: a report from the Children's Oncology Group. Cancer. 2007 Oct 1;110(7):1542-50. [https://doi.org/10.1002/cncr.22961 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17705175 PubMed] | # Nicholson HS, Kretschmar CS, Krailo M, Bernstein M, Kadota R, Fort D, Friedman H, Harris MB, Tedeschi-Blok N, Mazewski C, Sato J, Reaman GH; Children's Oncology Group. Phase 2 study of temozolomide in children and adolescents with recurrent central nervous system tumors: a report from the Children's Oncology Group. Cancer. 2007 Oct 1;110(7):1542-50. [https://doi.org/10.1002/cncr.22961 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17705175 PubMed] | ||
| − | |||
[[Category:Low-grade glioma regimens]] | [[Category:Low-grade glioma regimens]] | ||
[[Category:Disease-specific pages]] | [[Category:Disease-specific pages]] | ||
[[Category:Low-grade gliomas]] | [[Category:Low-grade gliomas]] | ||
[[Category:Pediatric neurologic neoplasms]] | [[Category:Pediatric neurologic neoplasms]] | ||
Revision as of 00:12, 1 March 2023
Section editor transclusions This page contains studies that are specific to pediatric populations. For the more general low-grade glioma category page, follow this link.
7 regimens on this page
11 variants on this page
|
Adjuvant therapy
Carboplatin & Vincristine
CV: Carboplatin & Vincristine
VC: Vincristine & Carboplatin
Regimen variant #1, 175/1.5 (capped vincristine)
| Study | Years of enrollment | Evidence | Comparator | Comparative Efficacy |
|---|---|---|---|---|
| Packer et al. 1993 | NR | Non-randomized | ||
| Ater et al. 2012 (COG A9952) | 1997-2005 | Phase 3 (C) | TPCV | Did not meet primary endpoints of EFS/OS |
Note: The course begins on day 0.
Preceding treatment
Chemotherapy
- Carboplatin (Paraplatin) 175 mg/m2 IV once per day on days 0, 7, 14, 21, 42, 49, 56, 63
- Vincristine (Oncovin) 1.5 mg/m2 (maximum dose of 2 mg) IV once per day on days 0, 7, 14, 21, 28, 35, 42, 49, 56, 63
10-week course
Subsequent treatment
- CV maintenance
Regimen variant #2, 550/1.5 (uncapped vincristine)
| Study | Years of enrollment | Evidence | Comparator | Comparative Efficacy |
|---|---|---|---|---|
| Gnekow et al. 2017 (SIOP-LCG 2004) | 2004-2012 | Phase 3 (C) | VCE | Did not meet primary endpoint of PFS |
Preceding treatment
Chemotherapy
- Carboplatin (Paraplatin) 550 mg/m2 IV over 60 minutes once on day 1
- Vincristine (Oncovin) as follows:
- Cycles 1 to 4: 1.5 mg/m2 IV once per day on days 1, 8, 15
- Cycles 5 to 7: 1.5 mg/m2 IV once on day 1
21-day cycle for 4 cycles, then 28-day cycle for 3 cycles
Subsequent treatment
- CV consolidation
References
- Packer RJ, Lange B, Ater J, Nicholson HS, Allen J, Walker R, Prados M, Jakacki R, Reaman G, Needles MN, Phillips PC, Ryan J, Boyett JM, Geyer R, Finlay J. Carboplatin and vincristine for recurrent and newly diagnosed low-grade gliomas of childhood. J Clin Oncol. 1993 May;11(5):850-6. link to original article contains dosing details in manuscript PubMed
- COG A9952: Ater JL, Zhou T, Holmes E, Mazewski CM, Booth TN, Freyer DR, Lazarus KH, Packer RJ, Prados M, Sposto R, Vezina G, Wisoff JH, Pollack IF. Randomized study of two chemotherapy regimens for treatment of low-grade glioma in young children: a report from the Children's Oncology Group. J Clin Oncol. 2012 Jul 20;30(21):2641-7. Epub 2012 Jun 4. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00002944
- SIOP-LGG 2004: Gnekow AK, Walker DA, Kandels D, Picton S, Perilongo G, Grill J, Stokland T, Sandstrom PE, Warmuth-Metz M, Pietsch T, Giangaspero F, Schmidt R, Faldum A, Kilmartin D, De Paoli A, De Salvo GL; of the Low Grade Glioma Consortium and the participating centers. A European randomised controlled trial of the addition of etoposide to standard vincristine and carboplatin induction as part of an 18-month treatment programme for childhood (≤16 years) low grade glioma - a final report. Eur J Cancer. 2017 Aug;81:206-225. Epub 2017 Jun 22. Erratum in: Eur J Cancer. 2017 Dec 13;:. link to original article link to PMC article contains dosing details in manuscript PubMed
Recurrent or progressive, non-curative therapy
Cisplatin & Etoposide (EP)
Regimen
| Study | Evidence |
|---|---|
| Massimino et al. 2010 | Non-randomized |
Note: In children less than 1 year old or less than 10 kg, "doses were adjusted to their weight"--reference does not say exactly how doses are adjusted.
Chemotherapy
- Cisplatin (Platinol) 25 mg/m2 IV over 2 hours once per day on days 1 to 3, given first
- Etoposide (Vepesid) 100 mg/m2 IV over 30 minutes once per day on days 1 to 3, given second
Supportive therapy
- Hydration for 2 hours before chemotherapy, and for 2 hours after chemotherapy
28-day cycle for 4 cycles, then 35-day cycle for 3 cycles, then 42-day cycle for 3 cycles
References
- Massimino M, Spreafico F, Riva D, Biassoni V, Poggi G, Solero C, Gandola L, Genitori L, Modena P, Simonetti F, Potepan P, Casanova M, Meazza C, Clerici CA, Catania S, Sardi I, Giangaspero F. A lower-dose, lower-toxicity cisplatin-etoposide regimen for childhood progressive low-grade glioma. J Neurooncol. 2010 Oct;100(1):65-71. Epub 2010 Feb 12. link to original article contains dosing details in manuscript PubMed
Temozolomide monotherapy
Regimen variant #1
| Study | Years of enrollment | Evidence |
|---|---|---|
| Nicholson et al. 2007 | 1998-1999 | Non-randomized |
Note: This dosing is for patients who previously received craniospinal irradiation (CSI).
Chemotherapy
- Temozolomide (Temodar) 180 mg/m2 PO once per day on days 1 to 5
28-day cycle for 11 cycles
Regimen variant #2
| Study | Years of enrollment | Evidence |
|---|---|---|
| Nicholson et al. 2007 | 1998-1999 | Non-randomized |
Chemotherapy
- Temozolomide (Temodar) 200 mg/m2 PO once per day on days 1 to 5
28-day cycle for 11 cycles
References
- Nicholson HS, Kretschmar CS, Krailo M, Bernstein M, Kadota R, Fort D, Friedman H, Harris MB, Tedeschi-Blok N, Mazewski C, Sato J, Reaman GH; Children's Oncology Group. Phase 2 study of temozolomide in children and adolescents with recurrent central nervous system tumors: a report from the Children's Oncology Group. Cancer. 2007 Oct 1;110(7):1542-50. link to original article contains dosing details in manuscript PubMed