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Gemcitabine/nab-paclitaxel for pediatric relapsed/refractory sarcomas.
Metts, Jonathan L; Alazraki, Adina L; Clark, Dana; Amankwah, Ernest K; Wasilewski-Masker, Karen J; George, Bradley A; Olson, Thomas A; Cash, Thomas.
Afiliação
  • Metts JL; Department of Pediatrics, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia.
  • Alazraki AL; Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
  • Clark D; Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland.
  • Amankwah EK; Department of Radiology and Imaging Sciences, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia.
  • Wasilewski-Masker KJ; Department of Pharmacy, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia.
  • George BA; Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida.
  • Olson TA; Department of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland.
  • Cash T; Department of Pediatrics, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta and Emory University, Atlanta, Georgia.
Pediatr Blood Cancer ; 65(9): e27246, 2018 09.
Article em En | MEDLINE | ID: mdl-29770997
BACKGROUND: Pediatric patients with relapsed/refractory sarcomas have poor outcomes and need novel therapies that provide disease control while maintaining an acceptable quality of life. The activity and toxicity of gemcitabine and nab-paclitaxel in combination has not been reported in pediatrics. PROCEDURE: We reviewed the records of fifteen relapsed/refractory patients and one treatment-naïve patient who received gemcitabine/nab-paclitaxel at our institution. RESULTS: Sixteen patients (median age 13.5 years, range 3-19 years) received 53 cycles of gemcitabine/nab-paclitaxel. Twenty-nine cycles (55%) resulted in ≥Grade 3 toxicity, with nonhematologic Grade ≥3 toxicities occurring in only eight of 53 cycles (15%). Patients received red blood cell and platelet transfusions in 23% and 4% of cycles, respectively. Grade ≥3 infectious toxicities occurred in 4% of cycles. Of 14 patients with measurable disease, there were no complete responses (CR), one partial response (PR; 7%), and six patients (43%) with stable disease (SD; median SD: 4.5 months, range: 2-19 months). In total, 31% of the patients derived clinical benefit (CR + PR + SD ≥ 4 months). Median time to progression was 72 days with a 4-month progression-free survival of 31% ± 12% and 1-year overall survival of 19% ± 10%. With a median follow-up for all 16 patients of 21 months from the first treatment with gemcitabine/nab-paclitaxel, one (6%) remains alive with disease. CONCLUSIONS: Gemcitabine/nab-paclitaxel is a relatively safe regimen with mainly hematologic toxicities. It offers a well-tolerated, palliative option providing clinical benefit in a subset of patients. A phase I trial of this combination is underway.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Sarcoma / Protocolos de Quimioterapia Combinada Antineoplásica / Terapia de Salvação Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Sarcoma / Protocolos de Quimioterapia Combinada Antineoplásica / Terapia de Salvação Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Male Idioma: En Ano de publicação: 2018 Tipo de documento: Article