Difference between revisions of "High-grade glioma, pediatric"
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[[#top|Back to Top]] | [[#top|Back to Top]] | ||
</div> | </div> | ||
− | {{#lst: | + | {{#lst:Editorial board transclusions|peds-neuro}} |
− | + | ''This page contains studies that are specific to pediatric populations. | |
+ | *For the more general '''high-grade glioma''' category page, follow '''[[:Category:High-grade_gliomas|this link]]'''. | ||
+ | *For '''pediatric low-grade glioma (pLGG)''', follow '''[[Low-grade glioma, pediatric|this link]]'''. | ||
{| class="wikitable" style="float:right; margin-right: 5px;" | {| class="wikitable" style="float:right; margin-right: 5px;" | ||
|- | |- | ||
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|} | |} | ||
{{TOC limit|limit=3}} | {{TOC limit|limit=3}} | ||
− | + | =Guidelines= | |
+ | '''Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.''' | ||
+ | ==NCCN== | ||
+ | *[https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1509 NCCN Guidelines - Pediatric Central Nervous System Cancers] | ||
=Adjuvant therapy= | =Adjuvant therapy= | ||
− | == | + | ==Temozolomide & RT {{#subobject:5fe805|Regimen=1}}== |
+ | Temozolomide & RT: Temozolomide & '''<u>R</u>'''adiation '''<u>T</u>'''herapy | ||
+ | <div class="toccolours" style="background-color:#eeeeee"> | ||
+ | ===Regimen {{#subobject:2a87ef|Variant=1}}=== | ||
+ | {| 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://doi.org/10.1200/JCO.2017.76.0611 Grill et al. 2018 (HERBY)] | ||
+ | |2011-2015 | ||
+ | | style="background-color:#1a9851" |Randomized Phase 2 (C) | ||
+ | |[[#Temozolomide.2C_Bevacizumab.2C_RT_999|Temozolomide, Bevacizumab, RT]] | ||
+ | | style="background-color:#ffffbf" |Did not meet primary endpoint of EFS | ||
+ | |- | ||
+ | |} | ||
+ | <div class="toccolours" style="background-color:#cbd5e8"> | ||
+ | ====Preceding treatment==== | ||
+ | *[[Surgery#CNS_cancer_surgery|Surgical biopsy, partial resection, or total resection]] | ||
+ | </div> | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
+ | ====Chemotherapy==== | ||
+ | *[[Temozolomide (Temodar)]] as follows: | ||
+ | **Cycle 1 (chemoradiation): 75 mg/m<sup>2</sup> PO or IV once per day on days 1 to 42 | ||
+ | **Cycles 2 to 13: 150 to 200 mg/m<sup>2</sup> PO once per day on days 1 to 5 | ||
+ | ====Radiotherapy==== | ||
+ | *Concurrent [[External_beam_radiotherapy|radiation therapy]] as follows: | ||
+ | **Cycle 1: 180 cGy fractions x 30 fractions, for a total dose of 5400 cGy | ||
+ | '''10-week course, then 28-day cycle for up to 12 cycles''' | ||
+ | </div></div> | ||
+ | ===References=== | ||
+ | #'''HERBY:''' Grill J, Massimino M, Bouffet E, Azizi AA, McCowage G, Cañete A, Saran F, Le Deley MC, Varlet P, Morgan PS, Jaspan T, Jones C, Giangaspero F, Smith H, Garcia J, Elze MC, Rousseau RF, Abrey L, Hargrave D, Vassal G. Phase II, open-label, randomized, multicenter trial (HERBY) of bevacizumab in pediatric patients with newly diagnosed high-grade glioma. J Clin Oncol. 2018 Apr 1;36(10):951-958. Epub 2018 Feb 7. [https://doi.org/10.1200/JCO.2017.76.0611 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/29412784/ PubMed] [https://clinicaltrials.gov/study/NCT01390948 NCT01390948] | ||
+ | ==VCP {{#subobject:f7dcb5|Regimen=1}}== | ||
+ | VCP: '''<u>V</u>'''incristine, '''<u>C</u>'''CNU (Lomustine), '''<u>P</u>'''rednisone | ||
+ | <div class="toccolours" style="background-color:#eeeeee"> | ||
===Regimen {{#subobject:251b74|Variant=1}}=== | ===Regimen {{#subobject:251b74|Variant=1}}=== | ||
{| class="wikitable sortable" style="width: 100%; text-align:center;" | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
!style="width: 20%"|Study | !style="width: 20%"|Study | ||
− | !style="width: 20%"| | + | !style="width: 20%"|Dates of enrollment |
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
!style="width: 20%"|Comparator | !style="width: 20%"|Comparator | ||
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | |[https://doi.org/10.1200/JCO.1995.13.1.112 Finlay et al. 1995] | + | |[https://doi.org/10.1200/JCO.1995.13.1.112 Finlay et al. 1995 (CCG-945)] |
|1985-1990 | |1985-1990 | ||
| style="background-color:#1a9851" |Phase 3 (C) | | style="background-color:#1a9851" |Phase 3 (C) | ||
Line 30: | Line 71: | ||
|- | |- | ||
|} | |} | ||
+ | ''Note: the exact schedule of vincristine is impossible to discern from Figure 1.'' | ||
+ | <div class="toccolours" style="background-color:#cbd5e8"> | ||
====Preceding treatment==== | ====Preceding treatment==== | ||
− | + | *[[Surgery#CNS_cancer_surgery|Surgery]], then adjuvant [[#Vincristine_.26_RT|Vincristine & RT]] | |
− | *[[Surgery#CNS_cancer_surgery|Surgery]], then Vincristine & RT | + | </div> |
− | + | <div class="toccolours" style="background-color:#b3e2cd"> | |
====Chemotherapy==== | ====Chemotherapy==== | ||
− | + | *[[Lomustine (CCNU)]] 100 mg/m<sup>2</sup> IV once on day 1 | |
− | *[[Lomustine (CCNU)]] | + | *[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> IV once per day on days 1, 8, 15 |
− | *[[Vincristine (Oncovin)]] | + | ====Glucocorticoid therapy==== |
− | *[[Prednisone (Sterapred)]] | + | *[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 14 |
− | + | '''42-day cycle for 8 cycles''' | |
+ | </div></div> | ||
===References=== | ===References=== | ||
− | + | #'''CCG-945:''' Finlay JL, Boyett JM, Yates AJ, Wisoff JH, Milstein JM, Geyer JR, Bertolone SJ, McGuire P, Cherlow JM, Tefft M, Turski PA, Wara WM, Edwards M, Sutton LN, Berger MS, Epstein F, Ayers G, Allen JC, Packer RJ; Children's Cancer Group. Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. J Clin Oncol. 1995 Jan;13(1):112-23. [https://doi.org/10.1200/JCO.1995.13.1.112 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/7799011/ PubMed] | |
− | #'''CCG-945:''' Finlay JL, Boyett JM, Yates AJ, Wisoff JH, Milstein JM, Geyer JR, Bertolone SJ, McGuire P, Cherlow JM, Tefft M, Turski PA, Wara WM, Edwards M, Sutton LN, Berger MS, Epstein F, Ayers G, Allen JC, Packer RJ; Children's Cancer Group. Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. J Clin Oncol. 1995 Jan;13(1):112-23. [https://doi.org/10.1200/JCO.1995.13.1.112 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7799011 PubMed] | + | ==Vincristine & RT {{#subobject:f7drt5|Regimen=1}}== |
− | + | Vincristine & RT: Vincristine & '''<u>R</u>'''adiation '''<u>T</u>'''herapy | |
− | == | + | <div class="toccolours" style="background-color:#eeeeee"> |
− | + | ===Regimen {{#subobject:rt1b74|Variant=1}}=== | |
− | |||
− | ===Regimen {{#subobject: | ||
{| class="wikitable sortable" style="width: 100%; text-align:center;" | {| class="wikitable sortable" style="width: 100%; text-align:center;" | ||
!style="width: 20%"|Study | !style="width: 20%"|Study | ||
− | !style="width: 20%"| | + | !style="width: 20%"|Dates of enrollment |
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | !style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
!style="width: 20%"|Comparator | !style="width: 20%"|Comparator | ||
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | !style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]] | ||
|- | |- | ||
− | |[https://doi.org/10.1200/JCO. | + | |[https://doi.org/10.1200/JCO.1995.13.1.112 Finlay et al. 1995 (CCG-945)] |
− | | | + | |1985-1990 |
− | | style="background-color:#1a9851" | | + | | style="background-color:#1a9851" |Phase 3 (C) |
− | | | + | |8-drug regimen |
− | | style="background-color:#ffffbf" |Did not meet primary endpoint of | + | | style="background-color:#ffffbf" |Did not meet primary endpoint of OS |
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#cbd5e8"> | ||
====Preceding treatment==== | ====Preceding treatment==== | ||
− | + | *[[Surgery#CNS_cancer_surgery|Surgery]] | |
− | *[[Surgery#CNS_cancer_surgery| | + | </div> |
− | + | <div class="toccolours" style="background-color:#b3e2cd"> | |
====Chemotherapy==== | ====Chemotherapy==== | ||
− | + | *[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> IV once per day on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64 | |
− | *[[ | ||
− | |||
− | |||
− | |||
====Radiotherapy==== | ====Radiotherapy==== | ||
− | + | *Concurrent [[External_beam_radiotherapy|radiation therapy]] | |
− | *Concurrent [[External_beam_radiotherapy|radiation therapy]] | + | '''70-day course''' |
− | + | </div> | |
− | + | <div class="toccolours" style="background-color:#cbd5e8"> | |
− | ''' | + | ====Subsequent treatment==== |
+ | *Adjuvant [[#VCP|VCP]] | ||
+ | </div></div> | ||
===References=== | ===References=== | ||
− | #''' | + | #'''CCG-945:''' Finlay JL, Boyett JM, Yates AJ, Wisoff JH, Milstein JM, Geyer JR, Bertolone SJ, McGuire P, Cherlow JM, Tefft M, Turski PA, Wara WM, Edwards M, Sutton LN, Berger MS, Epstein F, Ayers G, Allen JC, Packer RJ; Children's Cancer Group. Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. J Clin Oncol. 1995 Jan;13(1):112-23. [https://doi.org/10.1200/JCO.1995.13.1.112 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/7799011/ PubMed] |
=Recurrent disease, non-curative therapy, non-randomized or retrospective data= | =Recurrent disease, non-curative therapy, non-randomized or retrospective data= | ||
− | |||
==Temozolomide monotherapy {{#subobject:e73a18|Regimen=1}}== | ==Temozolomide monotherapy {{#subobject:e73a18|Regimen=1}}== | ||
− | + | <div class="toccolours" style="background-color:#eeeeee"> | |
===Regimen variant #1, no radiation history {{#subobject:f06af9|Variant=1}}=== | ===Regimen variant #1, no radiation history {{#subobject:f06af9|Variant=1}}=== | ||
{| class="wikitable sortable" style="width: 60%; text-align:center;" | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
!style="width: 33%"|Study | !style="width: 33%"|Study | ||
− | !style="width: 33%"| | + | !style="width: 33%"|Dates of enrollment |
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.1002/cncr.22961 Nicholson et al. 2007] |
|1998-1999 | |1998-1999 | ||
| style="background-color:#91cf61" |Non-randomized | | style="background-color:#91cf61" |Non-randomized | ||
|- | |- | ||
|} | |} | ||
+ | <div class="toccolours" style="background-color:#b3e2cd"> | ||
====Chemotherapy==== | ====Chemotherapy==== | ||
− | |||
*[[Temozolomide (Temodar)]] 150 to 200 mg/m<sup>2</sup> PO once per day on days 1 to 5 | *[[Temozolomide (Temodar)]] 150 to 200 mg/m<sup>2</sup> PO once per day on days 1 to 5 | ||
**Patients who previously received craniospinal irradiation (CSI) instead received 180 mg/m<sup>2</sup> PO once per day on days 1 to 5 | **Patients who previously received craniospinal irradiation (CSI) instead received 180 mg/m<sup>2</sup> PO once per day on days 1 to 5 | ||
− | |||
'''28-day cycle for up to 11 cycles''' | '''28-day cycle for up to 11 cycles''' | ||
− | + | </div></div><br> | |
+ | <div class="toccolours" style="background-color:#eeeeee"> | ||
===Regimen variant #2, previous craniospinal irradiation (CSI) {{#subobject:f06tf5|Variant=1}}=== | ===Regimen variant #2, previous craniospinal irradiation (CSI) {{#subobject:f06tf5|Variant=1}}=== | ||
{| class="wikitable sortable" style="width: 60%; text-align:center;" | {| class="wikitable sortable" style="width: 60%; text-align:center;" | ||
!style="width: 33%"|Study | !style="width: 33%"|Study | ||
− | !style="width: 33%"| | + | !style="width: 33%"|Dates of enrollment |
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | !style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]] | ||
|- | |- | ||
− | |[https:// | + | |[https://doi.org/10.1002/cncr.22961 Nicholson et al. 2007] |
|1998-1999 | |1998-1999 | ||
| style="background-color:#91cf61" |Non-randomized | | style="background-color:#91cf61" |Non-randomized | ||
|- | |- | ||
|} | |} | ||
+ | <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 up to 11 cycles''' | '''28-day cycle for up to 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:// | + | #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:High-grade glioma regimens]] | [[Category:High-grade glioma regimens]] |
Latest revision as of 00:25, 4 July 2024
Section editor | |
---|---|
Nicole M. Wood, DO University of Missouri Kansas City, MO, USA |
This page contains studies that are specific to pediatric populations.
- For the more general high-grade glioma category page, follow this link.
- For pediatric low-grade glioma (pLGG), follow this link.
4 regimens on this page
5 variants on this page
|
Guidelines
Given the rapid change in evidence in many areas of hematology/oncology, readers are encouraged to consider any guideline published 5+ years ago to be for historical purposes, only.
NCCN
Adjuvant therapy
Temozolomide & RT
Temozolomide & RT: Temozolomide & Radiation Therapy
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Grill et al. 2018 (HERBY) | 2011-2015 | Randomized Phase 2 (C) | Temozolomide, Bevacizumab, RT | Did not meet primary endpoint of EFS |
Preceding treatment
Chemotherapy
- Temozolomide (Temodar) as follows:
- Cycle 1 (chemoradiation): 75 mg/m2 PO or IV once per day on days 1 to 42
- Cycles 2 to 13: 150 to 200 mg/m2 PO once per day on days 1 to 5
Radiotherapy
- Concurrent radiation therapy as follows:
- Cycle 1: 180 cGy fractions x 30 fractions, for a total dose of 5400 cGy
10-week course, then 28-day cycle for up to 12 cycles
References
- HERBY: Grill J, Massimino M, Bouffet E, Azizi AA, McCowage G, Cañete A, Saran F, Le Deley MC, Varlet P, Morgan PS, Jaspan T, Jones C, Giangaspero F, Smith H, Garcia J, Elze MC, Rousseau RF, Abrey L, Hargrave D, Vassal G. Phase II, open-label, randomized, multicenter trial (HERBY) of bevacizumab in pediatric patients with newly diagnosed high-grade glioma. J Clin Oncol. 2018 Apr 1;36(10):951-958. Epub 2018 Feb 7. link to original article contains dosing details in manuscript PubMed NCT01390948
VCP
VCP: Vincristine, CCNU (Lomustine), Prednisone
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Finlay et al. 1995 (CCG-945) | 1985-1990 | Phase 3 (C) | 8-drug regimen | Did not meet primary endpoint of OS |
Note: the exact schedule of vincristine is impossible to discern from Figure 1.
Preceding treatment
- Surgery, then adjuvant Vincristine & RT
Chemotherapy
- Lomustine (CCNU) 100 mg/m2 IV once on day 1
- Vincristine (Oncovin) 1.5 mg/m2 IV once per day on days 1, 8, 15
Glucocorticoid therapy
- Prednisone (Sterapred) 40 mg/m2 PO once per day on days 1 to 14
42-day cycle for 8 cycles
References
- CCG-945: Finlay JL, Boyett JM, Yates AJ, Wisoff JH, Milstein JM, Geyer JR, Bertolone SJ, McGuire P, Cherlow JM, Tefft M, Turski PA, Wara WM, Edwards M, Sutton LN, Berger MS, Epstein F, Ayers G, Allen JC, Packer RJ; Children's Cancer Group. Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. J Clin Oncol. 1995 Jan;13(1):112-23. link to original article contains dosing details in manuscript PubMed
Vincristine & RT
Vincristine & RT: Vincristine & Radiation Therapy
Regimen
Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
---|---|---|---|---|
Finlay et al. 1995 (CCG-945) | 1985-1990 | Phase 3 (C) | 8-drug regimen | Did not meet primary endpoint of OS |
Preceding treatment
Chemotherapy
- Vincristine (Oncovin) 1.5 mg/m2 IV once per day on days 1, 8, 15, 22, 29, 36, 43, 50, 57, 64
Radiotherapy
- Concurrent radiation therapy
70-day course
Subsequent treatment
- Adjuvant VCP
References
- CCG-945: Finlay JL, Boyett JM, Yates AJ, Wisoff JH, Milstein JM, Geyer JR, Bertolone SJ, McGuire P, Cherlow JM, Tefft M, Turski PA, Wara WM, Edwards M, Sutton LN, Berger MS, Epstein F, Ayers G, Allen JC, Packer RJ; Children's Cancer Group. Randomized phase III trial in childhood high-grade astrocytoma comparing vincristine, lomustine, and prednisone with the eight-drugs-in-1-day regimen. J Clin Oncol. 1995 Jan;13(1):112-23. link to original article contains dosing details in manuscript PubMed
Recurrent disease, non-curative therapy, non-randomized or retrospective data
Temozolomide monotherapy
Regimen variant #1, no radiation history
Study | Dates of enrollment | Evidence |
---|---|---|
Nicholson et al. 2007 | 1998-1999 | Non-randomized |
Chemotherapy
- Temozolomide (Temodar) 150 to 200 mg/m2 PO once per day on days 1 to 5
- Patients who previously received craniospinal irradiation (CSI) instead received 180 mg/m2 PO once per day on days 1 to 5
28-day cycle for up to 11 cycles
Regimen variant #2, previous craniospinal irradiation (CSI)
Study | Dates of enrollment | Evidence |
---|---|---|
Nicholson et al. 2007 | 1998-1999 | Non-randomized |
Chemotherapy
- Temozolomide (Temodar) 180 mg/m2 PO once per day on days 1 to 5
28-day cycle for up to 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