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    Upfront window vincristine/irinotecan treatment of high-risk hepatoblastoma: A report from the Children's Oncology Group AHEP0731 study committee

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    Authors
    Katzenstein, Howard M.
    Furman, Wayne L.
    Malogolowkin, Marcio H.
    Krailo, Mark D.
    McCarville, M. Beth
    Towbin, Alexander J.
    Tiao, Greg M.
    Finegold, Milton J.
    Ranganathan, Sarangarajan
    Dunn, Stephen P.
    Langham, Max R.
    McGahren, Eugene D.
    Rodriguez-Galindo, Carlos
    Meyers, Rebecka L.
    Show allShow less
    UMass Chan Affiliations
    Quality Assurance Review Center
    Document Type
    Journal Article
    Publication Date
    2017-02-17
    Keywords
    Health Services Administration
    Neoplasms
    Oncology
    Pediatrics
    Radiology
    
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    Link to Full Text
    https://doi.org/10.1002/cncr.30591
    Abstract
    BACKGROUND: The identification of new therapies for high-risk (HR) hepatoblastoma is challenging. Children's Oncology Group study AHEP0731 included a HR stratum to explore the efficacy of novel agents. Herein, the authors report the response rate to the combination of vincristine (V) and irinotecan (I) and the outcome of patients with high-risk hepatoblastoma. METHODS: Patients with newly diagnosed metastatic hepatoblastoma or those with a serum alpha-fetoprotein (AFP) level /mL were eligible. Patients received 2 cycles of V at a dose of 1.5 mg/m2 /day intravenously on days 1 and 8 and I at a dose of 50 mg/m2 /day intravenously on days 1 to 5. Patients were defined as responders if they had either a 30% decrease in tumor burden according to Response Evaluation Criteria In Solid Tumors (RECIST) or a 90% ( > 1 log10 ) decline in their AFP level. Responders were to receive 2 additional cycles of VI intermixed with 6 cycles of the combination of cisplatin, doxorubicin, 5-fluorouracil, and vincristine (C5VD). Nonresponders were to receive 6 cycles of C5VD alone. RESULTS: A total of 32 patients with a median age at diagnosis of 26 months (range, 11-159 months) were enrolled between September 2009 and February 2012. Fourteen of 30 evaluable patients were responders (RECIST and AFP in 6 patients, RECIST only in 3 patients, and AFP only in 5 patients). The median AFP decline after 2 cycles of VI for the entire group was 345,565 ng/mL (85% of the initial AFP). The 3-year event-free and overall survival rates were 49% (95% confidence interval, 30%-65%) and 62% (95% confidence interval, 42%-77%), respectively. CONCLUSIONS: The VI combination appears to have substantial activity against HR hepatoblastoma. The ultimate impact of this regimen in improving the outcomes of children with HR hepatoblastoma remains to be determined. .
    Source
    Cancer. 2017 Feb 17. doi: 10.1002/cncr.30591. Link to article on publisher's site
    DOI
    10.1002/cncr.30591
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/46530
    PubMed ID
    28211941
    Related Resources
    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1002/cncr.30591
    Scopus Count
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    Radiation Oncology Publications

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