High-grade glioma, pediatric
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| Section editor | |
|---|---|
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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.
3 regimens on this page
4 variants on this page
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Guidelines
NCCN
Adjuvant therapy
Lomustine, Vincristine, Prednisone
Regimen
| Study | Dates of enrollment | Evidence | Comparator | Comparative Efficacy |
|---|---|---|---|---|
| Finlay et al. 1995 | 1985-1990 | Phase 3 (C) | 8-drug regimen | Did not meet primary endpoint of OS |
Preceding treatment
- Surgery, then Vincristine & RT
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 PubMed
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
- 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: 1.8 Gy fractions x 30 fractions, for a total dose of 54 Gy
6-week course, then 4-week break, 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
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