Intrathecal topotecan in adult patients with neoplastic meningitis
Authors
Gammon, David C.Bhatt, Mansi S.
Tran, Lan
Van Horn, Alexis
Benvenuti, Matthew
Glantz, Michael J.
UMass Chan Affiliations
Department of PharmacyDocument Type
Journal ArticlePublication Date
2006-10-24Keywords
Antineoplastic AgentsDrug Toxicity
Female
Humans
*Injections, Spinal
Male
Medical Audit
Meningeal Neoplasms
Middle Aged
Retrospective Studies
Topotecan
Treatment Outcome
Pharmacy and Pharmaceutical Sciences
Metadata
Show full item recordAbstract
PURPOSE: The efficacy and safety of intrathecal topotecan were assessed in patients with neoplastic meningitis (NM) by retrospective chart review. SUMMARY: Fourteen patients (median age, 57 years) with NM were treated with the standard of care (i.e., regional or systemic chemotherapy or irradiation or both) plus intrathecal topotecan between January 2004 and September 2005. Three patients developed NM in the setting of systemic cancer; 11 patients had primary central nervous system (CNS) malignancies. All patients received 0.4 mg of topotecan intrathecally two times per week. The efficacy of intrathecal topotecan was assessed on the basis of the number of doses to cerebrospinal fluid (CSF) cytologic clearing--defined as the disappearance of malignant cells from a previously positive CSF cytology. Safety was evaluated by chart documentation of adverse events that might have been associated with topotecan given intrathecally. Of the 11 patients with primary CNS tumors, 6 patients achieved CSF clearing after the first dose of intrathecal topotecan, 2 patients after the second dose, and 1 patient after the fifth dose. For the 3 patients with secondary CSF tumors, 1 patient achieved CSF clearing after the third dose and 2 patients did not reach the primary endpoint. Overall, 6 of the 14 patients achieved CSF clearing after the first dose of intrathecal topotecan; in 10 of the 14 patients, CSF clearing of malignant cells was observed at some point during treatment. Toxicity was modest. The most common adverse effect reported was fatigue. CONCLUSION: Intrathecal topotecan appeared to be effective and safe in adult patients with NM.Source
Am J Health Syst Pharm. 2006 Nov 1;63(21):2083-6. Link to article on publisher's siteDOI
10.2146/ajhp060165Permanent Link to this Item
http://hdl.handle.net/20.500.14038/26856PubMed ID
17057045Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.2146/ajhp060165