Difference between revisions of "Hepatoblastoma"

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m (Text replacement - "https://www.thelancet.com/journals/lanonc/article/PII" to "https://doi.org/10.1016/")
m (Text replacement - "http://www.ncbi.nlm.nih.gov/pmc" to "https://www.ncbi.nlm.nih.gov/pmc")
 
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{{#lst:Editorial board transclusions|blastomas}}
 
{| class="wikitable" style="float:right; margin-right: 5px;"
 
{| class="wikitable" style="float:right; margin-right: 5px;"
 
|-
 
|-
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|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
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|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
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<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
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<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
 
|}
 
|}
 
{{TOC limit|limit=3}}
 
{{TOC limit|limit=3}}
 +
=High-risk, upfront therapy=
 +
==COG AHEP0731 protocol H - responders {{#subobject:3a8i39|Regimen=1}}==
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen {{#subobject:a15cb47|Variant=1}}===
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy, VIT portion (cycles 1 & 2)====
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
  
−
=All lines of therapy=
+
*[[Irinotecan (Camptosar)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1.67 mg/kg (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
 +
**10 kg or more: 50 mg/m<sup>2</sup> (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
 +
====Targeted therapy, VIT portion (cycles 1 & 2)====
 +
*[[Temsirolimus (Torisel)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1.2 mg/kg IV over 30 minutes once per day on days 1 & 8
 +
**10 kg or more: 35 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 & 8
 +
 
 +
====Chemotherapy, C5VD portion (cycles 3 to 6)====
 +
*[[Cisplatin (Platinol)]] by the following weight-based criteria:
 +
**Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
 +
**10 kg or more: 100 mg/m<sup>2</sup> IV once over 6 hours on day 1
 +
 
 +
*[[Fluorouracil (5-FU)]] by the following weight-based criteria:
 +
**Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
 +
**10 kg or more: 600 mg/m<sup>2</sup> IV push over 2 to 4 minutes once on day 2
 +
 
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
 
 +
*[[Doxorubicin (Adriamycin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
 +
**10 kg or more: 30 mg/m<sup>2</sup> IV over 15 minutes once per day on days 1 & 2
 +
 
 +
====Chemotherapy, VIT portion (cycle 7)====
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
 +
 
 +
*[[Irinotecan (Camptosar)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1.67 mg/kg (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
 +
**10 kg or more: 50 mg/m<sup>2</sup> (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
 +
 
 +
====Targeted therapy, VIT portion (cycle 7)====
 +
*[[Temsirolimus (Torisel)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1.2 mg/kg IV over 30 minutes once per day on days 1 & 8
 +
**10 kg or more: 35 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 & 8
 +
 
 +
====Chemotherapy, C5VD portion (cycles 8 & 9)====
 +
*[[Cisplatin (Platinol)]] by the following weight-based criteria:
 +
**Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
 +
**10 kg or more: 100 mg/m<sup>2</sup> IV once over 6 hours on day 1
 +
 
 +
*[[Fluorouracil (5-FU)]] by the following weight-based criteria:
 +
**Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
 +
**10 kg or more: 600 mg/m<sup>2</sup> IV push over 2 to 4 minutes once on day 2
 +
 
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
 
 +
*[[Doxorubicin (Adriamycin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
 +
**10 kg or more: 30 mg/m<sup>2</sup> IV over 15 minutes once per day on days 1 & 2
 +
====Supportive therapy, C5VD portion (cycles 8 & 9)====
 +
*[[Dexrazoxane (Zinecard)]] by the following weight-based criteria:
 +
**Less than 10 kg: 10 mg/kg IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2
 +
**10 kg or more: 300 mg/m<sup>2</sup> IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2
 +
 
 +
====Chemotherapy, VIT portion (cycle 10)====
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
 +
 
 +
*[[Irinotecan (Camptosar)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1.67 mg/kg (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
 +
**10 kg or more: 50 mg/m<sup>2</sup> (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
 +
====Targeted therapy, VIT portion (cycle 10)====
 +
*[[Temsirolimus (Torisel)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1.2 mg/kg IV over 30 minutes once per day on days 1 & 8
 +
**10 kg or more: 35 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 & 8
 +
 
 +
'''21-day cycle for 10 cycles'''
 +
</div></div>
 +
===References===
 +
#None yet identified
 +
 
 +
==COG AHEP0731 protocol H - non-responders {{#subobject:3a882f|Regimen=1}}==
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen {{#subobject:a15cb47|Variant=2}}===
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy, VIT portion (cycles 1 & 2)====
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
 +
 
 +
*[[Irinotecan (Camptosar)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1.67 mg/kg (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
 +
**10 kg or more: 50 mg/m<sup>2</sup> (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
 +
 
 +
====Targeted therapy, VIT portion (cycles 1 & 2)====
 +
 
 +
*[[Temsirolimus (Torisel)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1.2 mg/kg IV over 30 minutes once per day on days 1 & 8
 +
**10 kg or more: 35 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 & 8
 +
 
 +
====Chemotherapy, C5VD portion (cycles 3 to 6)====
 +
*[[Cisplatin (Platinol)]] by the following weight-based criteria:
 +
**Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
 +
**10 kg or more: 100 mg/m<sup>2</sup> IV once over 6 hours on day 1
 +
 
 +
*[[Fluorouracil (5-FU)]] by the following weight-based criteria:
 +
**Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
 +
**10 kg or more: 600 mg/m<sup>2</sup> IV push over 2 to 4 minutes once on day 2
 +
 
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
 
 +
*[[Doxorubicin (Adriamycin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
 +
**10 kg or more: 30 mg/m<sup>2</sup> IV over 15 minutes once per day on days 1 & 2
 +
 
 +
====Chemotherapy, C5VD portion (cycles 7 to 8)====
 +
*[[Cisplatin (Platinol)]] by the following weight-based criteria:
 +
**Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
 +
**10 kg or more: 100 mg/m<sup>2</sup> IV once over 6 hours on day 1
 +
 
 +
*[[Fluorouracil (5-FU)]] by the following weight-based criteria:
 +
**Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
 +
**10 kg or more: 600 mg/m<sup>2</sup> IV push over 2 to 4 minutes once on day 2
 +
 
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
 
 +
*[[Doxorubicin (Adriamycin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
 +
**10 kg or more: 30 mg/m<sup>2</sup> IV over 15 minutes once per day on days 1 & 2
 +
 
 +
====Supportive therapy, C5VD portion (cycles 7 to 8)====
 +
*[[Dexrazoxane (Zinecard)]] by the following weight-based criteria:
 +
**Less than 10 kg: 10 mg/kg IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2
 +
**10 kg or more: 300 mg/m<sup>2</sup> IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2
 +
 
 +
'''21-day cycle for 8 cycles'''
 +
</div></div>
 +
===References===
 +
#None yet identified
 +
 
 +
==COG AHEP0731 protocol W {{#subobject:3a8i39|Regimen=1}}==
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen {{#subobject:a15cb47|Variant=1}}===
 +
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 +
!style="width: 33%"|Study
 +
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
|-
 +
|[https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5665173/ Katzenstein et al. 2017 (COG AHEP0731 HR)]
 +
|2009-09 to 2012-02
 +
| style="background-color:#91cf61" |Non-randomized
 +
|-
 +
|}
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Irinotecan (Camptosar)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1.67 mg/kg IV over 90 minutes once per day on days 1 to 5
 +
**10 kg or more: 50 mg/m<sup>2</sup> IV over 90 minutes once per day on days 1 to 5
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg IV once per day on days 1 & 8
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> IV once per day on days 1 & 8
 +
'''21-day cycle for 2 cycles'''
 +
</div>
 +
<div class="toccolours" style="background-color:#cbd5e8">
 +
====Subsequent treatment====
 +
*Depends on response; see paper for details
 +
</div></div>
 +
===References===
 +
#'''COG AHEP0731 HR:''' Katzenstein HM, Furman WL, Malogolowkin MH, Krailo MD, McCarville MB, Towbin AJ, Tiao GM, Finegold MJ, Ranganathan S, Dunn SP, Langham MR, McGahren ED, Rodriguez-Galindo C, Meyers RL. Upfront window vincristine/irinotecan treatment of high-risk hepatoblastoma: A report from the Children's Oncology Group AHEP0731 study committee. Cancer. 2017 Jun 15;123(12):2360-2367. Epub 2017 Feb 17. [https://doi.org/10.1002/cncr.30591 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5665173/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/28211941/ PubMed] [https://clinicaltrials.gov/study/NCT00980460 NCT00980460]
 +
 
 +
==SIOPEL-4 protocol, resectable after A3 {{#subobject:3a6ad9|Regimen=1}}==
 +
<div class="toccolours" style="background-color:#c8a2c8">
 +
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 +
!style="width: 33%"|Study
 +
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
|-
 +
|[https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3730732/ Zsiros et al. 2013 (SIOPEL-4)]
 +
|2005-01-01 to 2009-08-31
 +
| style="background-color:#91cf61" |Non-randomized
 +
|-
 +
|}
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Neoadjuvant, "Cycles A1, A2, A3" {{#subobject:59db47|Variant=1}}===
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Cisplatin (Platinol)]] as follows:
 +
**Cycle 1: 80 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on day 1, then 70 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on days 8 & 15 (total dose: 220 mg/m<sup>2</sup>)
 +
**Cycle 2: 70 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on days 1, 8, 15 (total dose: 210 mg/m<sup>2</sup>)
 +
**Cycle 3: 70 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on days 1 & 8 (total dose: 140 mg/m<sup>2</sup>)
 +
*[[Doxorubicin (Adriamycin)]] as follows:
 +
**Cycles 1 & 2: 30 mg/m<sup>2</sup>/day IV continuous infusion over 48 hours, started on day 8 (total dose per cycle: 60 mg/m<sup>2</sup>)
 +
**Cycle 3: 30 mg/m<sup>2</sup>/day IV continuous infusion over 48 hours, started on day 1 (total dose: 60 mg/m<sup>2</sup>)
 +
'''28-day cycle for 3 cycles, followed by determination of resectability, then:'''
 +
</div></div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Definitive===
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Local therapy====
 +
*[[Surgery#Surgical_resection|Surgical resection]], including liver transplantation and [[Surgery#Metastasectomy|metastasectomy]], if needed
 +
</div></div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Adjuvant, "Cycle C"===
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Carboplatin (Paraplatin)]] AUC 6.6 IV over 60 minutes once on day 1
 +
*[[Doxorubicin (Adriamycin)]] 20 mg/m<sup>2</sup>/day IV continuous infusion over 48 hours, started on day 1 (total dose per cycle: 40 mg/m<sup>2</sup>)
 +
'''21-day cycle for 3 cycles'''
 +
</div></div></div>
 +
===References===
 +
#'''SIOPEL-4:''' Zsiros J, Brugieres L, Brock P, Roebuck D, Maibach R, Zimmermann A, Childs M, Pariente D, Laithier V, Otte JB, Branchereau S, Aronson D, Rangaswami A, Ronghe M, Casanova M, Sullivan M, Morland B, Czauderna P, Perilongo G; International Childhood Liver Tumours Strategy Group (SIOPEL). Dose-dense cisplatin-based chemotherapy and surgery for children with high-risk hepatoblastoma (SIOPEL-4): a prospective, single-arm, feasibility study. Lancet Oncol. 2013 Aug;14(9):834-42. Epub 2013 Jul 4. [https://doi.org/10.1016/s1470-2045(13)70272-9 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3730732/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23831416/ PubMed] [https://clinicaltrials.gov/study/NCT00077389 NCT00077389]
 +
 
 +
==SIOPEL-4 protocol, unresectable after A3 {{#subobject:3aund9|Regimen=1}}==
 +
<div class="toccolours" style="background-color:#c8a2c8">
 +
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 +
!style="width: 33%"|Study
 +
!style="width: 33%"|Dates of enrollment
 +
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
|-
 +
|[https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3730732/ Zsiros et al. 2013 (SIOPEL-4)]
 +
|2005-01-01 to 2009-08-31
 +
| style="background-color:#91cf61" |Non-randomized
 +
|-
 +
|}
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Neoadjuvant, "Cycles A1, A2, A3" {{#subobject:5c4c47|Variant=1}}===
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Cisplatin (Platinol)]] as follows:
 +
**Cycle 1: 80 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on day 1, then 70 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on days 8 & 15 (total dose: 220 mg/m<sup>2</sup>)
 +
**Cycle 2: 70 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on days 1, 8, 15 (total dose: 210 mg/m<sup>2</sup>)
 +
**Cycle 3: 70 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on days 1 & 8 (total dose: 140 mg/m<sup>2</sup>)
 +
*[[Doxorubicin (Adriamycin)]] as follows:
 +
**Cycles 1 & 2: 30 mg/m<sup>2</sup>/day IV continuous infusion over 48 hours, started on day 8 (total dose per cycle: 60 mg/m<sup>2</sup>)
 +
**Cycle 3: 30 mg/m<sup>2</sup>/day IV continuous infusion over 48 hours, started on day 1 (total dose: 60 mg/m<sup>2</sup>)
 +
'''28-day cycle for 3 cycles, followed by determination of unresectability, then:'''
 +
</div></div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Neoadjuvant, "Cycle B"===
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Carboplatin (Paraplatin)]] AUC 10.6 IV over 60 minutes once on day 1
 +
*[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup>/day IV continuous infusion over 72 hours, started on day 1 (total dose per cycle: 75 mg/m<sup>2</sup>)
 +
'''21-day cycle for 2 cycles, followed by:'''
 +
</div></div><br>
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Definitive===
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Local therapy====
 +
*[[Surgery#Surgical_resection|Surgical resection]], including liver transplantation and [[Surgery#Metastasectomy|metastasectomy]], if needed
 +
</div></div></div>
 +
===References===
 +
#'''SIOPEL-4:''' Zsiros J, Brugieres L, Brock P, Roebuck D, Maibach R, Zimmermann A, Childs M, Pariente D, Laithier V, Otte JB, Branchereau S, Aronson D, Rangaswami A, Ronghe M, Casanova M, Sullivan M, Morland B, Czauderna P, Perilongo G; International Childhood Liver Tumours Strategy Group (SIOPEL). Dose-dense cisplatin-based chemotherapy and surgery for children with high-risk hepatoblastoma (SIOPEL-4): a prospective, single-arm, feasibility study. Lancet Oncol. 2013 Aug;14(9):834-42. Epub 2013 Jul 4. [https://doi.org/10.1016/s1470-2045(13)70272-9 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3730732/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23831416/ PubMed] [https://clinicaltrials.gov/study/NCT00077389 NCT00077389]
 +
 
 +
=Intermediate-risk, upfront therapy=
 +
==COG AHEP0731 protocol F {{#subobject:3a8i39|Regimen=1}}==
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen {{#subobject:a15cb47|Variant=1}}===
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy, C5VD portion (cycles 1 to 4)====
 +
*[[Cisplatin (Platinol)]] by the following weight-based criteria:
 +
**Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
 +
**10 kg or more: 100 mg/m<sup>2</sup> IV once over 6 hours on day 1
 +
 
 +
*[[Fluorouracil (5-FU)]] by the following weight-based criteria:
 +
**Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
 +
**10 kg or more: 600 mg/m<sup>2</sup> IV push over 2 to 4 minutes once on day 2
 +
 
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
 
 +
*[[Doxorubicin (Adriamycin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
 +
**10 kg or more: 30 mg/m<sup>2</sup> IV over 15 minutes once per day on days 1 & 2
 +
 
 +
====Chemotherapy, C5VD portion (cycles 5 & 6)====
 +
*[[Cisplatin (Platinol)]] by the following weight-based criteria:
 +
**Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
 +
**10 kg or more: 100 mg/m<sup>2</sup> IV once over 6 hours on day 1
 +
 
 +
*[[Fluorouracil (5-FU)]] by the following weight-based criteria:
 +
**Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
 +
**10 kg or more: 600 mg/m<sup>2</sup> IV push over 2 to 4 minutes once on day 2
 +
 
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
 
 +
*[[Doxorubicin (Adriamycin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
 +
**10 kg or more: 30 mg/m<sup>2</sup> IV over 15 minutes once per day on days 1 & 2
 +
====Supportive therapy, C5VD portion (cycles 5 & 6)====
 +
*[[Dexrazoxane (Zinecard)]] by the following weight-based criteria:
 +
**Less than 10 kg: 10 mg/kg IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2
 +
**10 kg or more: 300 mg/m<sup>2</sup> IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2
 +
 
 +
'''21-day cycle for 6 cycles'''
 +
</div></div>
 +
===References===
 +
#Not yet identified
 +
 
 +
=Low-risk, upfront therapy=
 +
==COG AHEP0731 protocol T {{#subobject:3a8i39|Regimen=1}}==
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen {{#subobject:a15cb47|Variant=1}}===
 +
<div class="toccolours" style="background-color:#cbd5e8">
 +
====Preceding treatment====
 +
*[[Surgery#Surgical_resection|Surgical resection]]
 +
</div>
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Cisplatin (Platinol)]] by the following weight-based criteria:
 +
**Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
 +
**10 kg or more: 100 mg/m<sup>2</sup> IV once over 6 hours on day 1
 +
 
 +
*[[Fluorouracil (5-FU)]] by the following weight-based criteria:
 +
**Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
 +
**10 kg or more: 600 mg/m<sup>2</sup> IV push over 2 to 4 minutes once on day 2
 +
 
 +
*[[Vincristine (Oncovin)]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
 +
 
 +
'''21-day cycle for 2 cycles'''
 +
</div></div>
 +
===References===
 +
#'''COG AHEP0731:''' Katzenstein HM, Langham MR, Malogolowkin MH, Krailo MD, Towbin AJ, McCarville MB, Finegold MJ, Ranganathan S, Dunn S, McGahren ED, Tiao GM, O'Neill AF, Qayed M, Furman WL, Xia C, Rodriguez-Galindo C, Meyers RL; Children's Oncology Group. Minimal adjuvant chemotherapy for children with hepatoblastoma resected at diagnosis (AHEP0731): a Children's Oncology Group, multicentre, phase 3 trial. Lancet Oncology. 2019 May 1. 20(5) 719-727. Epub 2019 Apr 8. [https://doi.org/10.1016/S1470-2045(18)30895-7 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6499702/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/30975630/ PubMed] [https://clinicaltrials.gov/study/NCT00980460 NCT00980460]
 +
 
 +
=Neoadjuvant therapy=
 
==Cisplatin monotherapy {{#subobject:ea894c|Regimen=1}}==
 
==Cisplatin monotherapy {{#subobject:ea894c|Regimen=1}}==
−
 
+
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:9134b2|Variant=1}}===
 
===Regimen {{#subobject:9134b2|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
!style="width: 17%"|Study
 
!style="width: 17%"|Study
−
!style="width: 15%"|Years of enrollment
+
!style="width: 15%"|Dates of enrollment
 
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 17%"|Comparator
 
!style="width: 17%"|Comparator
Line 23: Line 366:
 
| style="background-color:#1a9851" |Phase 3 (E-de-esc)
 
| style="background-color:#1a9851" |Phase 3 (E-de-esc)
 
|[[#Cisplatin_.26_Doxorubicin|Cisplatin & Doxorubicin]]
 
|[[#Cisplatin_.26_Doxorubicin|Cisplatin & Doxorubicin]]
−
| style="background-color:#eeee01" |Non-inferior complete resection rate
+
| style="background-color:#eeee01" |Non-inferior complete resection rate (primary endpoint)
 
|
 
|
 
|-
 
|-
Line 29: Line 372:
 
|2007-2014
 
|2007-2014
 
| style="background-color:#1a9851" |Phase 3 (C)
 
| style="background-color:#1a9851" |Phase 3 (C)
−
|[[#Cisplatin_.26_Sodium_thiosulfate_99|Cisplatin & Sodium thiosulfate]]
+
|[[#Cisplatin_.26_Sodium_thiosulfate_999|Cisplatin & Sodium thiosulfate]]
 
|
 
|
 
| style="background-color:#d73027" |More hearing loss
 
| style="background-color:#d73027" |More hearing loss
 
|-
 
|-
 
|}
 
|}
 +
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
−
*[[Cisplatin (Platinol)]]
+
*[[Cisplatin (Platinol)]] 80 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on day 1
 +
'''14-day cycle for 4 cycles'''
 +
</div></div>
 +
===References===
 +
# '''SIOPEL 3:''' Perilongo G, Maibach R, Shafford E, Brugieres L, Brock P, Morland B, de Camargo B, Zsiros J, Roebuck D, Zimmermann A, Aronson D, Childs M, Widing E, Laithier V, Plaschkes J, Pritchard J, Scopinaro M, MacKinlay G, Czauderna P. Cisplatin versus cisplatin plus doxorubicin for standard-risk hepatoblastoma. N Engl J Med. 2009 Oct 22;361(17):1662-70. [https://doi.org/10.1056/NEJMoa0810613 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19846851/ PubMed] [https://clinicaltrials.gov/study/NCT00003912 NCT00003912]
 +
# '''SIOPEL 6:''' Brock PR, Maibach R, Childs M, Rajput K, Roebuck D, Sullivan MJ, Laithier V, Ronghe M, Dall'Igna P, Hiyama E, Brichard B, Skeen J, Mateos ME, Capra M, Rangaswami AA, Ansari M, Rechnitzer C, Veal GJ, Covezzoli A, Brugières L, Perilongo G, Czauderna P, Morland B, Neuwelt EA. Sodium Thiosulfate for Protection from Cisplatin-Induced Hearing Loss. N Engl J Med. 2018 Jun 21;378(25):2376-2385. [https://doi.org/10.1056/nejmoa1801109 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6117111/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/29924955/ PubMed] [https://clinicaltrials.gov/study/NCT00652132 NCT00652132]
  
 +
=Adjuvant therapy=
 +
==Cisplatin & Fluorouracil (CF) & Vincristine {{#subobject:50f9da|Regimen=1}}==
 +
<div class="toccolours" style="background-color:#eeeeee">
 +
===Regimen===
 +
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 +
!style="width: 20%"|Study
 +
!style="width: 20%"|Dates of enrollment
 +
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 +
!style="width: 20%"|Comparator
 +
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 +
|-
 +
|[https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6499702/ Katzenstein et al. 2019 (COG AHEP0731)]
 +
|2010-2014
 +
| style="background-color:#1a9851" |Phase 3 (E-esc)
 +
|[[#Observation|Observation]]
 +
| style="background-color:#91cf60" |Seems to have superior EFS (primary endpoint)
 +
|-
 +
|}
 +
''For stage 1 or 2 '''hepatoblastoma''' without 100% pure fetal stage I or small-cell undifferentiated histology with complete resection at diagnosis and no history of prior chemotherapy or liver directed therapy. Eligible patients include: patients< 21 years old, elevated serum α-fetoprotein level (>100 ng/mL), at least 50% Karnofsky (patients >16 years) or Lansky (patients ≤16 years) performance status.''
 +
<div class="toccolours" style="background-color:#cbd5e8">
 +
====Preceding treatment====
 +
*Curative [[Surgery#Hepatobiliary_cancer_surgery|surgical resection]]
 +
</div>
 +
<div class="toccolours" style="background-color:#b3e2cd">
 +
====Chemotherapy====
 +
*[[Cisplatin (Platinol)]] by the following weight-based criteria:
 +
**Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
 +
**10 kg or more: 100 mg/m<sup>2</sup> over 6 hours once on day 1
 +
*[[Fluorouracil (5-FU)|Fluorouracil]] by the following weight-based criteria:
 +
**Less than 10 kg: 20 mg/kg IV once on day 2
 +
**10 kg or more: 600 mg/m<sup>2</sup> IV once on day 2
 +
*[[Vincristine (Oncovin)|Vincristine]] by the following weight-based criteria:
 +
**Less than 10 kg: 0.05 mg/kg IV once per day on days 2, 9, 16
 +
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 2, 9, 16
 +
'''21-day course; to be given within 42 days of resection'''
 +
</div></div>
 
===References===
 
===References===
−
# '''SIOPEL 3:''' Perilongo G, Maibach R, Shafford E, Brugieres L, Brock P, Morland B, de Camargo B, Zsiros J, Roebuck D, Zimmermann A, Aronson D, Childs M, Widing E, Laithier V, Plaschkes J, Pritchard J, Scopinaro M, MacKinlay G, Czauderna P. Cisplatin versus cisplatin plus doxorubicin for standard-risk hepatoblastoma. N Engl J Med. 2009 Oct 22;361(17):1662-70. [https://doi.org/10.1056/NEJMoa0810613 link to original article] [https://pubmed.ncbi.nlm.nih.gov/19846851 PubMed] NCT00003912
+
#'''COG AHEP0731:''' Katzenstein HM, Langham MR, Malogolowkin MH, Krailo MD, Towbin AJ, McCarville MB, Finegold MJ, Ranganathan S, Dunn S, McGahren ED, Tiao GM, O'Neill AF, Qayed M, Furman WL, Xia C, Rodriguez-Galindo C, Meyers RL; Children's Oncology Group. Minimal adjuvant chemotherapy for children with hepatoblastoma resected at diagnosis (AHEP0731): a Children's Oncology Group, multicentre, phase 3 trial. Lancet Oncology. 2019 May 1. 20(5) 719-727. Epub 2019 Apr 8. [https://doi.org/10.1016/S1470-2045(18)30895-7 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6499702/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/30975630/ PubMed] [https://clinicaltrials.gov/study/NCT00980460 NCT00980460]
−
# '''SIOPEL 6:''' Brock PR, Maibach R, Childs M, Rajput K, Roebuck D, Sullivan MJ, Laithier V, Ronghe M, Dall'Igna P, Hiyama E, Brichard B, Skeen J, Mateos ME, Capra M, Rangaswami AA, Ansari M, Rechnitzer C, Veal GJ, Covezzoli A, Brugières L, Perilongo G, Czauderna P, Morland B, Neuwelt EA. Sodium Thiosulfate for Protection from Cisplatin-Induced Hearing Loss. N Engl J Med. 2018 Jun 21;378(25):2376-2385. [https://doi.org/10.1056/nejmoa1801109 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6117111/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/29924955/ PubMed] NCT00652132
 
  
 +
=All lines of therapy=
 
==Cisplatin & Doxorubicin {{#subobject:7bb59c|Regimen=1}}==
 
==Cisplatin & Doxorubicin {{#subobject:7bb59c|Regimen=1}}==
−
 
 
PLADO: '''<u>PLA</u>'''tinol (Cisplatin) & '''<u>DO</u>'''xorubicin
 
PLADO: '''<u>PLA</u>'''tinol (Cisplatin) & '''<u>DO</u>'''xorubicin
 +
<div class="toccolours" style="background-color:#eeeeee">
 
===Regimen {{#subobject:c48515|Variant=1}}===
 
===Regimen {{#subobject:c48515|Variant=1}}===
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
{| class="wikitable sortable" style="width: 100%; text-align:center;"  
 
!style="width: 17%"|Study
 
!style="width: 17%"|Study
−
!style="width: 15%"|Years of enrollment
+
!style="width: 15%"|Dates of enrollment
 
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
!style="width: 17%"|Comparator
 
!style="width: 17%"|Comparator
Line 56: Line 441:
 
|1989-1992
 
|1989-1992
 
| style="background-color:#1a9851" |Phase 3 (E-switch-ic)
 
| style="background-color:#1a9851" |Phase 3 (E-switch-ic)
−
|[[#Cisplatin_.26_Fluorouracil_.28CF.29_.26_Vincristine_88|CF & Vincristine]]
+
|[[#Cisplatin_.26_Fluorouracil_.28CF.29_.26_Vincristine_888|CF & Vincristine]]
 
|
 
|
−
| style="background-color:#d73027" |More toxic
+
| style="background-color:#d73027" |More toxic (primary endpoint)
 
|-
 
|-
 
|[https://doi.org/10.1200/jco.2000.18.22.3819 Pritchard et al. 2000 (SIOPEL 1)]
 
|[https://doi.org/10.1200/jco.2000.18.22.3819 Pritchard et al. 2000 (SIOPEL 1)]
Line 75: Line 460:
 
|-
 
|-
 
|}
 
|}
 +
''Note: the duration of cycles was not specified.'''
 +
<div class="toccolours" style="background-color:#b3e2cd">
 
====Chemotherapy====
 
====Chemotherapy====
−
*[[Cisplatin (Platinol)]]
+
*[[Cisplatin (Platinol)]] by the following age-based criteria:
−
*[[Doxorubicin (Adriamycin)]]
+
**Younger than 1 year old: 3 mg/kg IV over 6 hours once on day 1, '''given first'''
−
 
+
**1 year old or older: 90 mg/m<sup>2</sup> IV over 6 hours once on day 1, '''given first'''
−
===References===
+
*[[Doxorubicin (Adriamycin)]] 20 mg/m<sup>2</sup>/day IV continuous infusion over 96 hours, started on day 1, '''given second''' (total dose per cycle: 80 mg/m<sup>2</sup>)
−
# Ortega JA, Douglass EC, Feusner JH, Reynolds M, Quinn JJ, Finegold MJ, Haas JE, King DR, Liu-Mares W, Sensel MG, Krailo MD; Children's Cancer Group; Pediatric Oncology Group. Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: a report from the Children's Cancer Group and the Pediatric Oncology Group. J Clin Oncol. 2000 Jul;18(14):2665-75. [https://doi.org/10.1200/JCO.2000.18.14.2665 link to original article] [https://pubmed.ncbi.nlm.nih.gov/10894865 PubMed]
+
'''4 cycles'''
−
# '''SIOPEL 1:''' Pritchard J, Brown J, Shafford E, Perilongo G, Brock P, Dicks-Mireaux C, Keeling J, Phillips A, Vos A, Plaschkes J. Cisplatin, doxorubicin, and delayed surgery for childhood hepatoblastoma: a successful approach--results of the first prospective study of the International Society of Pediatric Oncology. J Clin Oncol. 2000 Nov 15;18(22):3819-28. [https://doi.org/10.1200/jco.2000.18.22.3819 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11078495 PubMed]
+
</div></div>
−
# '''SIOPEL 3:''' Perilongo G, Maibach R, Shafford E, Brugieres L, Brock P, Morland B, de Camargo B, Zsiros J, Roebuck D, Zimmermann A, Aronson D, Childs M, Widing E, Laithier V, Plaschkes J, Pritchard J, Scopinaro M, MacKinlay G, Czauderna P. Cisplatin versus cisplatin plus doxorubicin for standard-risk hepatoblastoma. N Engl J Med. 2009 Oct 22;361(17):1662-70. [https://doi.org/10.1056/NEJMoa0810613 link to original article] [https://pubmed.ncbi.nlm.nih.gov/19846851 PubMed] NCT00003912
 
−
 
 
−
==Cisplatin & Fluorouracil (CF) & Vincristine {{#subobject:50f9da|Regimen=1}}==
 
−
 
 
−
===Regimen===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1016/S1470-2045(18)30895-7 Katzenstein et al. 2019 (AHEP0731)]
 
−
|2010-2014
 
−
| style="background-color:#1a9851" |Phase 3 (E-esc)
 
−
|[[#Observation|Observation]]
 
−
| style="background-color:#91cf60" |Seems to have superior EFS
 
−
|-
 
−
|}
 
−
''For stage 1 or 2 '''hepatoblastoma''' without 100% pure fetal stage I or small-cell undifferentiated histology with complete resection at diagnosis and no history of prior chemotherapy or liver directed therapy. Eligible patients include: patients< 21 years old, elevated serum α-fetoprotein level (>100 ng/mL), at least 50% Karnofsky (patients >16 years) or Lansky (patients ≤16 years) performance status.''
 
−
 
 
−
====Preceding treatment====
 
−
 
 
−
*Curative [[Surgery#Hepatobiliary_cancer_surgery|surgical resection]]
 
−
 
 
−
====Chemotherapy====
 
−
 
 
−
*[[Cisplatin (Platinol)]] by the following weight-based criteria:
 
−
**Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
 
−
**10 kg or more: 100 mg/m<sup>2</sup> over 6 hours once on day 1
 
−
*[[Fluorouracil (5-FU)|Fluorouracil]] by the following weight-based criteria:
 
−
**Less than 10 kg: 20 mg/kg IV once on day 2
 
−
**10 kg or more: 600 mg/m<sup>2</sup> IV once on day 2
 
−
*[[Vincristine (Oncovin)|Vincristine]] by the following weight-based criteria:
 
−
**Less than 10 kg: 0.05 mg/kg IV once per day on days 2, 9, 16
 
−
**10 kg or more: 1.5 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 2, 9, 16
 
−
 
 
−
'''21-day cycle for 1 cycle (to be given within 42 days of resection)'''
 
−
 
 
 
===References===
 
===References===
−
 
+
# Ortega JA, Douglass EC, Feusner JH, Reynolds M, Quinn JJ, Finegold MJ, Haas JE, King DR, Liu-Mares W, Sensel MG, Krailo MD; Children's Cancer Group; Pediatric Oncology Group. Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: a report from the Children's Cancer Group and the Pediatric Oncology Group. J Clin Oncol. 2000 Jul;18(14):2665-75. [https://doi.org/10.1200/JCO.2000.18.14.2665 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/10894865/ PubMed]
−
#'''AHEP0731:''' Katzenstein HM, Langham MR, Malogolowkin MH, Krailo MD, Towbin AJ, McCarville MB, Finegold MJ, Ranganathan S, Dunn S, McGahren ED, Tiao GM, O'Neill AF, Qayed M, Furman WL, Xia C, Rodriguez-Galindo C, Meyers RL; Children's Oncology Group. Minimal adjuvant chemotherapy for children with hepatoblastoma resected at diagnosis (AHEP0731): a Children's Oncology Group, multicentre, phase 3 trial. Lancet Oncology. 2019 May 1. 20(5) 719-727. Epub 2019 Apr 8. [https://doi.org/10.1016/S1470-2045(18)30895-7 link to original article] [https://pubmed.ncbi.nlm.nih.gov/30975630/ PubMed] NCT00980460
+
# '''SIOPEL 1:''' Pritchard J, Brown J, Shafford E, Perilongo G, Brock P, Dicks-Mireaux C, Keeling J, Phillips A, Vos A, Plaschkes J. Cisplatin, doxorubicin, and delayed surgery for childhood hepatoblastoma: a successful approach--results of the first prospective study of the International Society of Pediatric Oncology. J Clin Oncol. 2000 Nov 15;18(22):3819-28. [https://doi.org/10.1200/jco.2000.18.22.3819 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11078495/ PubMed]
−
 
+
# '''SIOPEL 3:''' Perilongo G, Maibach R, Shafford E, Brugieres L, Brock P, Morland B, de Camargo B, Zsiros J, Roebuck D, Zimmermann A, Aronson D, Childs M, Widing E, Laithier V, Plaschkes J, Pritchard J, Scopinaro M, MacKinlay G, Czauderna P. Cisplatin versus cisplatin plus doxorubicin for standard-risk hepatoblastoma. N Engl J Med. 2009 Oct 22;361(17):1662-70. [https://doi.org/10.1056/NEJMoa0810613 link to original article] [https://pubmed.ncbi.nlm.nih.gov/19846851/ PubMed] [https://clinicaltrials.gov/study/NCT00003912 NCT00003912]
 
[[Category:Hepatoblastoma regimens]]
 
[[Category:Hepatoblastoma regimens]]
 
[[Category:Disease-specific pages]]
 
[[Category:Disease-specific pages]]
 
[[Category:Pediatric solid tumors]]
 
[[Category:Pediatric solid tumors]]

Latest revision as of 12:12, 23 June 2024

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Section editor
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 Elaine Fan, MD
KU School of Medicine
Wichita, KS, USA
LinkedIn
7 regimens on this page
7 variants on this page


High-risk, upfront therapy

COG AHEP0731 protocol H - responders

Regimen

Chemotherapy, VIT portion (cycles 1 & 2)

  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
  • Irinotecan (Camptosar) by the following weight-based criteria:
    • Less than 10 kg: 1.67 mg/kg (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
    • 10 kg or more: 50 mg/m2 (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5

Targeted therapy, VIT portion (cycles 1 & 2)

  • Temsirolimus (Torisel) by the following weight-based criteria:
    • Less than 10 kg: 1.2 mg/kg IV over 30 minutes once per day on days 1 & 8
    • 10 kg or more: 35 mg/m2 IV over 30 minutes once per day on days 1 & 8

Chemotherapy, C5VD portion (cycles 3 to 6)

  • Cisplatin (Platinol) by the following weight-based criteria:
    • Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
    • 10 kg or more: 100 mg/m2 IV once over 6 hours on day 1
  • Fluorouracil (5-FU) by the following weight-based criteria:
    • Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
    • 10 kg or more: 600 mg/m2 IV push over 2 to 4 minutes once on day 2
  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
  • Doxorubicin (Adriamycin) by the following weight-based criteria:
    • Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
    • 10 kg or more: 30 mg/m2 IV over 15 minutes once per day on days 1 & 2

Chemotherapy, VIT portion (cycle 7)

  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
  • Irinotecan (Camptosar) by the following weight-based criteria:
    • Less than 10 kg: 1.67 mg/kg (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
    • 10 kg or more: 50 mg/m2 (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5

Targeted therapy, VIT portion (cycle 7)

  • Temsirolimus (Torisel) by the following weight-based criteria:
    • Less than 10 kg: 1.2 mg/kg IV over 30 minutes once per day on days 1 & 8
    • 10 kg or more: 35 mg/m2 IV over 30 minutes once per day on days 1 & 8

Chemotherapy, C5VD portion (cycles 8 & 9)

  • Cisplatin (Platinol) by the following weight-based criteria:
    • Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
    • 10 kg or more: 100 mg/m2 IV once over 6 hours on day 1
  • Fluorouracil (5-FU) by the following weight-based criteria:
    • Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
    • 10 kg or more: 600 mg/m2 IV push over 2 to 4 minutes once on day 2
  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
  • Doxorubicin (Adriamycin) by the following weight-based criteria:
    • Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
    • 10 kg or more: 30 mg/m2 IV over 15 minutes once per day on days 1 & 2

Supportive therapy, C5VD portion (cycles 8 & 9)

  • Dexrazoxane (Zinecard) by the following weight-based criteria:
    • Less than 10 kg: 10 mg/kg IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2
    • 10 kg or more: 300 mg/m2 IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2

Chemotherapy, VIT portion (cycle 10)

  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
  • Irinotecan (Camptosar) by the following weight-based criteria:
    • Less than 10 kg: 1.67 mg/kg (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
    • 10 kg or more: 50 mg/m2 (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5

Targeted therapy, VIT portion (cycle 10)

  • Temsirolimus (Torisel) by the following weight-based criteria:
    • Less than 10 kg: 1.2 mg/kg IV over 30 minutes once per day on days 1 & 8
    • 10 kg or more: 35 mg/m2 IV over 30 minutes once per day on days 1 & 8

21-day cycle for 10 cycles

References

  1. None yet identified

COG AHEP0731 protocol H - non-responders

Regimen

Chemotherapy, VIT portion (cycles 1 & 2)

  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV push or infusion once per day on days 1 & 8
  • Irinotecan (Camptosar) by the following weight-based criteria:
    • Less than 10 kg: 1.67 mg/kg (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5
    • 10 kg or more: 50 mg/m2 (maximum dose of 100 mg) IV over 90 minutes once per day on days 1 to 5

Targeted therapy, VIT portion (cycles 1 & 2)

  • Temsirolimus (Torisel) by the following weight-based criteria:
    • Less than 10 kg: 1.2 mg/kg IV over 30 minutes once per day on days 1 & 8
    • 10 kg or more: 35 mg/m2 IV over 30 minutes once per day on days 1 & 8

Chemotherapy, C5VD portion (cycles 3 to 6)

  • Cisplatin (Platinol) by the following weight-based criteria:
    • Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
    • 10 kg or more: 100 mg/m2 IV once over 6 hours on day 1
  • Fluorouracil (5-FU) by the following weight-based criteria:
    • Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
    • 10 kg or more: 600 mg/m2 IV push over 2 to 4 minutes once on day 2
  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
  • Doxorubicin (Adriamycin) by the following weight-based criteria:
    • Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
    • 10 kg or more: 30 mg/m2 IV over 15 minutes once per day on days 1 & 2

Chemotherapy, C5VD portion (cycles 7 to 8)

  • Cisplatin (Platinol) by the following weight-based criteria:
    • Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
    • 10 kg or more: 100 mg/m2 IV once over 6 hours on day 1
  • Fluorouracil (5-FU) by the following weight-based criteria:
    • Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
    • 10 kg or more: 600 mg/m2 IV push over 2 to 4 minutes once on day 2
  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
  • Doxorubicin (Adriamycin) by the following weight-based criteria:
    • Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
    • 10 kg or more: 30 mg/m2 IV over 15 minutes once per day on days 1 & 2

Supportive therapy, C5VD portion (cycles 7 to 8)

  • Dexrazoxane (Zinecard) by the following weight-based criteria:
    • Less than 10 kg: 10 mg/kg IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2
    • 10 kg or more: 300 mg/m2 IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2

21-day cycle for 8 cycles

References

  1. None yet identified

COG AHEP0731 protocol W

Regimen

Study Dates of enrollment Evidence
Katzenstein et al. 2017 (COG AHEP0731 HR) 2009-09 to 2012-02 Non-randomized

Chemotherapy

  • Irinotecan (Camptosar) by the following weight-based criteria:
    • Less than 10 kg: 1.67 mg/kg IV over 90 minutes once per day on days 1 to 5
    • 10 kg or more: 50 mg/m2 IV over 90 minutes once per day on days 1 to 5
  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg IV once per day on days 1 & 8
    • 10 kg or more: 1.5 mg/m2 IV once per day on days 1 & 8

21-day cycle for 2 cycles

Subsequent treatment

  • Depends on response; see paper for details

References

  1. COG AHEP0731 HR: Katzenstein HM, Furman WL, Malogolowkin MH, Krailo MD, McCarville MB, Towbin AJ, Tiao GM, Finegold MJ, Ranganathan S, Dunn SP, Langham MR, McGahren ED, Rodriguez-Galindo C, Meyers RL. Upfront window vincristine/irinotecan treatment of high-risk hepatoblastoma: A report from the Children's Oncology Group AHEP0731 study committee. Cancer. 2017 Jun 15;123(12):2360-2367. Epub 2017 Feb 17. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00980460

SIOPEL-4 protocol, resectable after A3

Study Dates of enrollment Evidence
Zsiros et al. 2013 (SIOPEL-4) 2005-01-01 to 2009-08-31 Non-randomized

Neoadjuvant, "Cycles A1, A2, A3"

Chemotherapy

  • Cisplatin (Platinol) as follows:
    • Cycle 1: 80 mg/m2 IV continuous infusion over 24 hours, started on day 1, then 70 mg/m2 IV continuous infusion over 24 hours, started on days 8 & 15 (total dose: 220 mg/m2)
    • Cycle 2: 70 mg/m2 IV continuous infusion over 24 hours, started on days 1, 8, 15 (total dose: 210 mg/m2)
    • Cycle 3: 70 mg/m2 IV continuous infusion over 24 hours, started on days 1 & 8 (total dose: 140 mg/m2)
  • Doxorubicin (Adriamycin) as follows:
    • Cycles 1 & 2: 30 mg/m2/day IV continuous infusion over 48 hours, started on day 8 (total dose per cycle: 60 mg/m2)
    • Cycle 3: 30 mg/m2/day IV continuous infusion over 48 hours, started on day 1 (total dose: 60 mg/m2)

28-day cycle for 3 cycles, followed by determination of resectability, then:


Definitive

Local therapy


Adjuvant, "Cycle C"

Chemotherapy

21-day cycle for 3 cycles

References

  1. SIOPEL-4: Zsiros J, Brugieres L, Brock P, Roebuck D, Maibach R, Zimmermann A, Childs M, Pariente D, Laithier V, Otte JB, Branchereau S, Aronson D, Rangaswami A, Ronghe M, Casanova M, Sullivan M, Morland B, Czauderna P, Perilongo G; International Childhood Liver Tumours Strategy Group (SIOPEL). Dose-dense cisplatin-based chemotherapy and surgery for children with high-risk hepatoblastoma (SIOPEL-4): a prospective, single-arm, feasibility study. Lancet Oncol. 2013 Aug;14(9):834-42. Epub 2013 Jul 4. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00077389

SIOPEL-4 protocol, unresectable after A3

Study Dates of enrollment Evidence
Zsiros et al. 2013 (SIOPEL-4) 2005-01-01 to 2009-08-31 Non-randomized

Neoadjuvant, "Cycles A1, A2, A3"

Chemotherapy

  • Cisplatin (Platinol) as follows:
    • Cycle 1: 80 mg/m2 IV continuous infusion over 24 hours, started on day 1, then 70 mg/m2 IV continuous infusion over 24 hours, started on days 8 & 15 (total dose: 220 mg/m2)
    • Cycle 2: 70 mg/m2 IV continuous infusion over 24 hours, started on days 1, 8, 15 (total dose: 210 mg/m2)
    • Cycle 3: 70 mg/m2 IV continuous infusion over 24 hours, started on days 1 & 8 (total dose: 140 mg/m2)
  • Doxorubicin (Adriamycin) as follows:
    • Cycles 1 & 2: 30 mg/m2/day IV continuous infusion over 48 hours, started on day 8 (total dose per cycle: 60 mg/m2)
    • Cycle 3: 30 mg/m2/day IV continuous infusion over 48 hours, started on day 1 (total dose: 60 mg/m2)

28-day cycle for 3 cycles, followed by determination of unresectability, then:


Neoadjuvant, "Cycle B"

Chemotherapy

21-day cycle for 2 cycles, followed by:


Definitive

Local therapy

References

  1. SIOPEL-4: Zsiros J, Brugieres L, Brock P, Roebuck D, Maibach R, Zimmermann A, Childs M, Pariente D, Laithier V, Otte JB, Branchereau S, Aronson D, Rangaswami A, Ronghe M, Casanova M, Sullivan M, Morland B, Czauderna P, Perilongo G; International Childhood Liver Tumours Strategy Group (SIOPEL). Dose-dense cisplatin-based chemotherapy and surgery for children with high-risk hepatoblastoma (SIOPEL-4): a prospective, single-arm, feasibility study. Lancet Oncol. 2013 Aug;14(9):834-42. Epub 2013 Jul 4. link to original article link to PMC article contains dosing details in manuscript PubMed NCT00077389

Intermediate-risk, upfront therapy

COG AHEP0731 protocol F

Regimen

Chemotherapy, C5VD portion (cycles 1 to 4)

  • Cisplatin (Platinol) by the following weight-based criteria:
    • Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
    • 10 kg or more: 100 mg/m2 IV once over 6 hours on day 1
  • Fluorouracil (5-FU) by the following weight-based criteria:
    • Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
    • 10 kg or more: 600 mg/m2 IV push over 2 to 4 minutes once on day 2
  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
  • Doxorubicin (Adriamycin) by the following weight-based criteria:
    • Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
    • 10 kg or more: 30 mg/m2 IV over 15 minutes once per day on days 1 & 2

Chemotherapy, C5VD portion (cycles 5 & 6)

  • Cisplatin (Platinol) by the following weight-based criteria:
    • Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
    • 10 kg or more: 100 mg/m2 IV once over 6 hours on day 1
  • Fluorouracil (5-FU) by the following weight-based criteria:
    • Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
    • 10 kg or more: 600 mg/m2 IV push over 2 to 4 minutes once on day 2
  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
  • Doxorubicin (Adriamycin) by the following weight-based criteria:
    • Less than 10 kg: 1 mg/kg IV over 15 minutes once per day on days 1 & 2
    • 10 kg or more: 30 mg/m2 IV over 15 minutes once per day on days 1 & 2

Supportive therapy, C5VD portion (cycles 5 & 6)

  • Dexrazoxane (Zinecard) by the following weight-based criteria:
    • Less than 10 kg: 10 mg/kg IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2
    • 10 kg or more: 300 mg/m2 IV over 5 to 15 minutes immediately prior to doxorubicin on days 1 & 2

21-day cycle for 6 cycles

References

  1. Not yet identified

Low-risk, upfront therapy

COG AHEP0731 protocol T

Regimen

Preceding treatment

Chemotherapy

  • Cisplatin (Platinol) by the following weight-based criteria:
    • Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
    • 10 kg or more: 100 mg/m2 IV once over 6 hours on day 1
  • Fluorouracil (5-FU) by the following weight-based criteria:
    • Less than 10 kg: 20 mg/kg IV push over 2 to 4 minutes once on day 2
    • 10 kg or more: 600 mg/m2 IV push over 2 to 4 minutes once on day 2
  • Vincristine (Oncovin) by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV push or infusion once per day on days 2, 9, 16

21-day cycle for 2 cycles

References

  1. COG AHEP0731: Katzenstein HM, Langham MR, Malogolowkin MH, Krailo MD, Towbin AJ, McCarville MB, Finegold MJ, Ranganathan S, Dunn S, McGahren ED, Tiao GM, O'Neill AF, Qayed M, Furman WL, Xia C, Rodriguez-Galindo C, Meyers RL; Children's Oncology Group. Minimal adjuvant chemotherapy for children with hepatoblastoma resected at diagnosis (AHEP0731): a Children's Oncology Group, multicentre, phase 3 trial. Lancet Oncology. 2019 May 1. 20(5) 719-727. Epub 2019 Apr 8. link to original article link to PMC article PubMed NCT00980460

Neoadjuvant therapy

Cisplatin monotherapy

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy Comparative Toxicity
Perilongo et al. 2009 (SIOPEL 3) 1998-2006 Phase 3 (E-de-esc) Cisplatin & Doxorubicin Non-inferior complete resection rate (primary endpoint)
Brock et al. 2018 (SIOPEL 6) 2007-2014 Phase 3 (C) Cisplatin & Sodium thiosulfate More hearing loss

Chemotherapy

14-day cycle for 4 cycles

References

  1. SIOPEL 3: Perilongo G, Maibach R, Shafford E, Brugieres L, Brock P, Morland B, de Camargo B, Zsiros J, Roebuck D, Zimmermann A, Aronson D, Childs M, Widing E, Laithier V, Plaschkes J, Pritchard J, Scopinaro M, MacKinlay G, Czauderna P. Cisplatin versus cisplatin plus doxorubicin for standard-risk hepatoblastoma. N Engl J Med. 2009 Oct 22;361(17):1662-70. link to original article contains dosing details in manuscript PubMed NCT00003912
  2. SIOPEL 6: Brock PR, Maibach R, Childs M, Rajput K, Roebuck D, Sullivan MJ, Laithier V, Ronghe M, Dall'Igna P, Hiyama E, Brichard B, Skeen J, Mateos ME, Capra M, Rangaswami AA, Ansari M, Rechnitzer C, Veal GJ, Covezzoli A, Brugières L, Perilongo G, Czauderna P, Morland B, Neuwelt EA. Sodium Thiosulfate for Protection from Cisplatin-Induced Hearing Loss. N Engl J Med. 2018 Jun 21;378(25):2376-2385. link to original article link to PMC article PubMed NCT00652132

Adjuvant therapy

Cisplatin & Fluorouracil (CF) & Vincristine

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy
Katzenstein et al. 2019 (COG AHEP0731) 2010-2014 Phase 3 (E-esc) Observation Seems to have superior EFS (primary endpoint)

For stage 1 or 2 hepatoblastoma without 100% pure fetal stage I or small-cell undifferentiated histology with complete resection at diagnosis and no history of prior chemotherapy or liver directed therapy. Eligible patients include: patients< 21 years old, elevated serum α-fetoprotein level (>100 ng/mL), at least 50% Karnofsky (patients >16 years) or Lansky (patients ≤16 years) performance status.

Preceding treatment

Chemotherapy

  • Cisplatin (Platinol) by the following weight-based criteria:
    • Less than 10 kg: 3.3 mg/kg IV over 6 hours once on day 1
    • 10 kg or more: 100 mg/m2 over 6 hours once on day 1
  • Fluorouracil by the following weight-based criteria:
    • Less than 10 kg: 20 mg/kg IV once on day 2
    • 10 kg or more: 600 mg/m2 IV once on day 2
  • Vincristine by the following weight-based criteria:
    • Less than 10 kg: 0.05 mg/kg IV once per day on days 2, 9, 16
    • 10 kg or more: 1.5 mg/m2 (maximum dose of 2 mg) IV once per day on days 2, 9, 16

21-day course; to be given within 42 days of resection

References

  1. COG AHEP0731: Katzenstein HM, Langham MR, Malogolowkin MH, Krailo MD, Towbin AJ, McCarville MB, Finegold MJ, Ranganathan S, Dunn S, McGahren ED, Tiao GM, O'Neill AF, Qayed M, Furman WL, Xia C, Rodriguez-Galindo C, Meyers RL; Children's Oncology Group. Minimal adjuvant chemotherapy for children with hepatoblastoma resected at diagnosis (AHEP0731): a Children's Oncology Group, multicentre, phase 3 trial. Lancet Oncology. 2019 May 1. 20(5) 719-727. Epub 2019 Apr 8. link to original article link to PMC article PubMed NCT00980460

All lines of therapy

Cisplatin & Doxorubicin

PLADO: PLAtinol (Cisplatin) & DOxorubicin

Regimen

Study Dates of enrollment Evidence Comparator Comparative Efficacy Comparative Toxicity
Ortega et al. 2000 1989-1992 Phase 3 (E-switch-ic) CF & Vincristine More toxic (primary endpoint)
Pritchard et al. 2000 (SIOPEL 1) 1990-1994 Non-randomized
Perilongo et al. 2009 (SIOPEL 3) 1998-2006 Phase 3 (C) Cisplatin Non-inferior complete resection rate

Note: the duration of cycles was not specified.'

Chemotherapy

  • Cisplatin (Platinol) by the following age-based criteria:
    • Younger than 1 year old: 3 mg/kg IV over 6 hours once on day 1, given first
    • 1 year old or older: 90 mg/m2 IV over 6 hours once on day 1, given first
  • Doxorubicin (Adriamycin) 20 mg/m2/day IV continuous infusion over 96 hours, started on day 1, given second (total dose per cycle: 80 mg/m2)

4 cycles

References

  1. Ortega JA, Douglass EC, Feusner JH, Reynolds M, Quinn JJ, Finegold MJ, Haas JE, King DR, Liu-Mares W, Sensel MG, Krailo MD; Children's Cancer Group; Pediatric Oncology Group. Randomized comparison of cisplatin/vincristine/fluorouracil and cisplatin/continuous infusion doxorubicin for treatment of pediatric hepatoblastoma: a report from the Children's Cancer Group and the Pediatric Oncology Group. J Clin Oncol. 2000 Jul;18(14):2665-75. link to original article contains dosing details in manuscript PubMed
  2. SIOPEL 1: Pritchard J, Brown J, Shafford E, Perilongo G, Brock P, Dicks-Mireaux C, Keeling J, Phillips A, Vos A, Plaschkes J. Cisplatin, doxorubicin, and delayed surgery for childhood hepatoblastoma: a successful approach--results of the first prospective study of the International Society of Pediatric Oncology. J Clin Oncol. 2000 Nov 15;18(22):3819-28. link to original article PubMed
  3. SIOPEL 3: Perilongo G, Maibach R, Shafford E, Brugieres L, Brock P, Morland B, de Camargo B, Zsiros J, Roebuck D, Zimmermann A, Aronson D, Childs M, Widing E, Laithier V, Plaschkes J, Pritchard J, Scopinaro M, MacKinlay G, Czauderna P. Cisplatin versus cisplatin plus doxorubicin for standard-risk hepatoblastoma. N Engl J Med. 2009 Oct 22;361(17):1662-70. link to original article PubMed NCT00003912
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