Clinical features and management of carboplatin-related hypersensitivity reactions in pediatric low-grade glioma

Genc, Dildar Bahar; Canpolat, Cengiz; Berrak, Su Gülsün

doi:10.1007/s00520-011-1123-y

Cited by 35 publications

(39 citation statements)

References 31 publications

(57 reference statements)

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“…As a summary, only four of 19 (21 %) patients (four of 50 (8 %) LGG patients) were given corticosteroids. In our manuscript [2], we also recommend antihistamines±desensitization protocol at first CHR episode and try to avoid routine administration of corticosteroids.…”

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confidence: 97%

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confidence: 98%

“…Fortunately, in the past few years, there have been many studies in the field of pediatric neurooncology, which indicate effectiveness of many second-line drugs such as cisplatin/etoposide, vinblastine, vinorelbine, temozolamide, etc. [2][3][4]. Today, we are lucky to have more therapy options in case of CHR.…”

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confidence: 99%

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Response letter to the editor

Genc

Canpolat

Berrak

2012

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Dear Editor, We thank Dr Lafay-Cousin for her interest in our study [1,2].Our study population was composed of 50 low-grade glioma (LGG) patients and 20 of them developed carboplatin-related hypersensitivity reactions (CHR). Four out of 19 re-exposed patients at first episode and two out of eight patients at second episode were started on corticosteroids as part of their modification regimen. Two of these six patients developed CHR again and their carboplatin therapy was terminated. As a summary, only four of 19 (21 %) patients (four of 50 (8 %) LGG patients) were given corticosteroids. In our manuscript [2], we also recommend antihistamines±desensitization protocol at first CHR episode and try to avoid routine administration of corticosteroids.Our study [2] is a retrospective evaluation of carboplatin hypersensitivity reactions in low-grade glioma patients treated between 1997 and 2008. The choice of chemotherapy during this period was a combination of carboplatin and vincristine. Fortunately, in the past few years, there have been many studies in the field of pediatric neurooncology, which indicate effectiveness of many second-line drugs such as cisplatin/etoposide, vinblastine, vinorelbine, temozolamide, etc. [2][3][4]. Today, we are lucky to have more therapy options in case of CHR. In accordance with this information, we recommended that carboplatin re-exposure could be tried especially in cases responding to therapy and the potential risks should not outweigh the benefits of continuing to carboplatin.The report from Children Oncology Group showed that LGG patients with NF1 electively treated with vincristine and carboplatin had significantly better EFS in comparison to those without NF1. Thus, better tumor control expectancy in NF1 patients validates continuation of carboplatin by means antihistamines and desensitization protocols in case of CHR [5].In conclusion, we agree that LGG is a chronic disease necessitating recurrent therapy episodes. In patients where carboplatin termination is a must-despite efforts of premedication and desensitization-choice of antineoplastic agent should be carefully entertained according to acute and chronic toxicity profiles and rate of tumor control.

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Response letter to the editor

Genc

Canpolat

Berrak

2012

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“…Surgical excision of the tumor is recommended as the primary treatment. However, because of its infiltration into normal brain tissue and the specificity of its growing locations (Ong et al, 2009), the tumor usually cannot be removed completely and thus adjuvant radiotherapy and/or chemotherapy have to be employed so as to kill the rest of the tumor (Genc et al, 2011). Treatment of gliomas is complicated by the tumors' high resistance to chemotherapy, poor penetration of blood brain barrier (BBB), and damaging effects of chemotherapy and radiation to normal neural tissue (Lefranc et al, 2006).…”

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Preparation and evaluation of nanoparticles loading plasmid DNAs inserted with siRNA fragments targeting c-Myc gene

Jiang

Liu

et al. 2014

Pharmaceutical Biology

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Context: c-Myc plays a key role in glioma cancer stem cell maintenance. A drug delivery system, nanoparticles loading plasmid DNAs inserted with siRNA fragments targeting c-Myc gene (NPsc-Myc-siRNA-pDNAs), for the treatment of glioma, has not previously been reported. Objective: NPs-c-Myc-siRNA-pDNAs were prepared and evaluated in vitro. Materials and methods: Three kinds of c-Myc-siRNA fragments were separately synthesized and linked with empty siRNA expression vectors in the mole ratio of 3:1 by T4 DNA ligase. The linked products were then separately transfected into Escherichia coli. DH5a followed by extraction with Endofree plasmid Mega kit (Qiagen, Hilden, Germany) obtained c-Myc-siRNA-pDNAs. Finally, the recombinant c-Myc-siRNA3-pDNAs, generating the highest transfection efficiency and the greatest apoptotic ability, were chosen for encapsulation into NPs by the double-emulsion solvent-evaporation procedure, followed by stability, transfection efficiency, as well as qualitative and quantitative apoptosis evaluation. Results: NPs-c-Myc-siRNA3-pDNAs were obtained with spherical shape in uniform size below 150 nm, with the zeta potential about À18 mV, the encapsulation efficiency and loading capacity as 76.3 ± 5.4% and 1.91 ± 0.06%, respectively. The stability results showed that c-Myc-siRNA3-pDNAs remained structurally and functionally stable after encapsulated into NPs, and NPs could prevent the loaded c-Myc-siRNA3-pDNAs from DNase degradation. The transfection efficiency of NPs-c-Myc-siRNA3-pDNAs was proven to be positive. Furthermore, NPs-c-Myc-siRNA3-pDNAs produced significant apoptosis with the apoptotic rate at 24.77 ± 5.39% and early apoptosis cells observed. Discussion and conclusion: Methoxy-poly-(ethylene-glycol)-poly-(lactide-co-glycolide) nanoparticles (MPEG-PLGA-NPs) are potential delivery carriers for c-Myc-siRNA3-pDNAs.

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“…6 We were not able to detect any significant differences at a higher radiation dose, possibly due to the insensitivity of our method. 4 leading to treatment withdrawal and the use of second-line drugs. Additionally, carboplatin administered in association with vincristine has been found to be a risk factor for adverse events, 5 raising the incidence to 68% of children treated.…”

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confidence: 99%