Chemotherapy of advanced neuroblastoma: does adriamycin contribute?

Ninane, J.; Pritchard, Jon; Malpas, J. S.

doi:10.1136/adc.56.7.544

Cited by 46 publications

(8 citation statements)

References 12 publications

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“…Advanced neuroblastoma is one of the most aggressive forms of childhood cancer and patients aged >1 year at diagnosis with stage 4 disease have a particularly poor prognosis 1–4. Induction chemotherapy schedules, usually cisplatin‐based, developed in the 1980s and 1990s are associated with higher response rates and longer median survival than those achieved prior to that time 4,5.…”

Section: Introductionmentioning

confidence: 99%

High dose melphalan in the treatment of advanced neuroblastoma: Results of a randomised trial (ENSG‐1) by the European Neuroblastoma Study Group

Pritchard

Cotterill

Germond

et al. 2004

Pediatric Blood & Cancer

163

110

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In this trial, high dose melphalan improved the length of EFS and overall survival of children with stage IV neuroblastoma >1 year of age who achieved CR or GPR after OPEC induction therapy and surgery. Multi-agent myeloablative regimens are now widely used as consolidation therapy for children with stage IV disease and in those with other disease stages when the MYCN gene copy number in tumour cells is amplified. Because they are more toxic, complex, and costly these combination megatherapy regimens should be compared with single agent melphalan in randomised clinical trials.

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Section: Introductionmentioning

confidence: 99%

High dose melphalan in the treatment of advanced neuroblastoma: Results of a randomised trial (ENSG‐1) by the European Neuroblastoma Study Group

Pritchard

Cotterill

Germond

et al. 2004

Pediatric Blood & Cancer

163

110

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“…Progression-free survival beyond 3 years was around 10%. (Ninane et al, 1981;Finklestein et al, 1979;Nitschke et al, 1980). The addition of other agents such as mustine and DTIC had little impact (Rosen et al, 1984).…”

mentioning

confidence: 99%

Short duration, high dose, alternating chemotherapy in metastatic neuroblastoma. (ENSG 3C induction regimen)

Pinkerton

Zucker²,

Hartmann³

et al. 1990

Br J Cancer

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Summary Fifty-one children, aged from 15 months to 13 years 5 months with metastatic neuroblastoma presenting sequentially at the participating institutions received four 3 to 4 weekly courses of high dose multiagent chemotherapy. High dose cisplatin (200mg m2) combined with etoposide (500mg m2), HIPE, was alternated with ifosfamide (9 g m2), vincristine (1.5 mg m2), and adriamycin (60mg m-'), IVAd

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“…Though anthracyclines are quoted as a major drug in meta analysis (Cheung and Heller, 1991), its exact role was challenged (Ninane et al, 1981). We thus took the opportunity to test it in resistant patients.…”

Section: Discussionmentioning

confidence: 99%

The LMCE5 unselected cohort of 25 children consecutively diagnosed with untreated stage 4 neuroblastoma over 1 year at diagnosis

et al. 2002

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The Lyon-Marseille-Curie-Est (LMCE) of France cooperative group has previously reported successive series of unselected stage four children older than 1 year at diagnosis with metastatic neuroblastoma (LMCE 1 and 3). The goal of LMCE 5 study was to increase progression free survival rate as compared to LMCE 1 and 3. Based on improvements reported with post induction chemotherapy, the LMCE 5 used post induction for all children, but omitted total body irradiation and immunomagnetic purging in megatherapy regimen for all children. Twenty-five sequentially diagnosed children received an induction regimen which compared with previous induction included an increased dose of etoposide and cyclophosphamide, delivered similar dose of cisplatinum, and deleted doxorubicin and vincristin. After surgery treatment was stratified based on response and eligible children received etoposide carboplatin (LMCE 5A : n=10)+doxorubicin (LMCE 5B -C n=13) followed by megatherapy (melphalan without total body irradiation and unpurged peripheral blood stem cell rescue). The increase in drug doses during induction did not improve remission rate. The progression free survival at 6 years is 8%. It is significantly worse than LMCE 3, and equivalent to LMCE 1 study though toxic death rate has decreased with increasing experience. Failure to improve the response rate during induction and reducing the megatherapy regimen may be the main factors in this disappointing result. Modified strategies for induction, non toxic alternative to total body irradiation, and post megatherapy regimen should be developed.

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Chemotherapy of advanced neuroblastoma: does adriamycin contribute?

Cited by 46 publications

References 12 publications

High dose melphalan in the treatment of advanced neuroblastoma: Results of a randomised trial (ENSG‐1) by the European Neuroblastoma Study Group

High dose melphalan in the treatment of advanced neuroblastoma: Results of a randomised trial (ENSG‐1) by the European Neuroblastoma Study Group

Short duration, high dose, alternating chemotherapy in metastatic neuroblastoma. (ENSG 3C induction regimen)

The LMCE5 unselected cohort of 25 children consecutively diagnosed with untreated stage 4 neuroblastoma over 1 year at diagnosis

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