J Pediatr Hematol Oncol. 2000 May-Jun;22(3):247-51. doi: 10.1097/00043426-200005000-00010.

Tamoxifen and carboplatin for children with low-grade gliomas: a pilot study at St. Jude Children's Research Hospital.

Journal of pediatric hematology/oncology

A W Walter, A Gajjar, D A Reardon, S J Thompson, J W Langston, D Jones-Wallace, L E Kun, R L Heideman

PMID: 10864056 DOI: 10.1097/00043426-200005000-00010

Abstract

PURPOSE: The authors conducted a single-arm, prospective study using tamoxifen and carboplatin for the treatment of children with progressive or symptomatic low-grade gliomas.

PATIENTS AND METHODS: Fourteen children with consecutively diagnosed cases of low-grade glioma were enrolled in this Study; all patients were younger than 14 years. One patient was excluded after induction chemotherapy because of the diagnosis of a nonmalignant condition. Patients were treated with daily tamoxifen (20 mg/m2 administered twice per day) in addition to targeted, monthly intravenous carboplatin at an area under the curve (AUC) exposure of 6.5 mg/mL x minute for 1 year or until they had clinical or radiologic evidence of disease progression.

RESULTS: The median age at diagnosis was 5.3 years, the median age at initiation of chemotherapy was 8.3 years. Eight patients had tumors of the hypothalamus/optic pathway, two patients had thalamic tumors, and one patient each had tumors in the temporal lobe, tectum, and brain stem. Tumor histologic findings included fibrillary astrocytoma (n = 2), juvenile pilocytic astrocytoma (n = 6), and oligodendroglioma (n = 1). The best response to therapy was a partial response in two patients, stable disease in nine patients, and progressive disease in two patients. The overall survival at 3 years is 69%. The 3-year progression-free survival is 47%. Tamoxifen and carboplatin chemotherapy did not result in a significant number of objective responses in children with low-grade gliomas. The progression-free survival is similar to that of other published series. Nonmyelosuppressive agents such as tamoxifen deserve additional evaluation in the treatment of children with low-grade gliomas.

Substances

• Enzyme Inhibitors
• Tamoxifen
• Carboplatin
• Protein Kinase C

MeSH terms

• Antineoplastic Combined Chemotherapy Protocols / therapeutic use
• Astrocytoma / drug therapy
• Astrocytoma / mortality
• Brain Neoplasms / drug therapy
• Brain Neoplasms / mortality
• Carboplatin / administration & dosage
• Child
• Child, Preschool
• Disease Progression
• Disease-Free Survival
• Enzyme Inhibitors / administration & dosage
• Female
• Humans
• Life Tables
• Male
• Oligodendroglioma / drug therapy
• Oligodendroglioma / mortality
• Prospective Studies
• Protein Kinase C / antagonists & inhibitors
• Survival Analysis
• Survival Rate
• Tamoxifen / administration & dosage
• Treatment Outcome

Publication Types

• Journal Article
• Research Support, Non-U.S. Gov't
• Research Support, U.S. Gov't, P.H.S.

Grant support

• P01 CA-20180/CA/NCI NIH HHS/United States
• P01 CA-23099/CA/NCI NIH HHS/United States
• P30 CA-21765/CA/NCI NIH HHS/United States