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. 2022 Mar 9:12:804310.
doi: 10.3389/fonc.2022.804310. eCollection 2022.

Vincristine, Irinotecan, and Temozolomide in Patients With Relapsed/Refractory Neuroblastoma

Jia Zhu  1   2 , Juan Wang  1   2 , Feifei Sun  1   2 , Zijun Zhen  1   2 , Tingting Chen  1   2 , Suying Lu  1   2 , Junting Huang  1   2 , Yizhuo Zhang  1   2 , Xiaofei Sun  1   2
Affiliations

Vincristine, Irinotecan, and Temozolomide in Patients With Relapsed/Refractory Neuroblastoma

Jia Zhu et al. Front Oncol. .

Abstract

Purpose: The combination of irinotecan, temozolomide and vincristine has been proposed as an effective salvage regimen for some pediatric malignancies. Thus, we sought to evaluate this combination for patients with relapsed and refractory neuroblastoma (NB).

Patients and methods: In this retrospective study, forty-six patients with relapsed or refractory NB were treated with the combination of vincristine (1.5 mg/m2 i.v. day 1), irinotecan (50 mg/m2/day i.v. days 1-5) and temozolomide (100 mg/m2/day p.o. days 1-5) (VIT) during the period 2011-2019. All toxicities were documented.

Results: A total of 251 cycles (median 6 cycles/patient) were administered. A complete response (CR) was achieved in 5 patients, partial response (PR) in 27 patients, stable disease (SD) in 8 patients, and progression disease (PD) in 6 patients, with an overall objective response rate (CR+PR) of 69.6%. Eighteen patients developed diarrhea with Grade 3 or less. Grade 1-2 hematologic toxicity occurred in 10 patients. Grade 3-4 hematologic toxicity developed in 32 patients. VIT was an effective regimen for different metastatic sites. UGT1A*28 genotyping performed in 7 patients revealed wild type. Diarrhea occurred in 4 of them.

Conclusion: The shorter, 5-day VIT regimen is an active and well-tolerated salvage regimen in relapse/refractory NB.

Keywords: efficacy; irinotecan; neuroblastoma; refractory; relapse; temozolomide; toxicity; vincristine.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Survival rates from the initiation of VIT to progression or relapse. (months).
See this image and copyright information in PMC

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