Conflict of interest: Nothing to declare.
A multi-center phase Ib study of oxaliplatin (NSC#266046) in combination with fluorouracil and leucovorin in pediatric patients with advanced solid tumors†
Article first published online: 28 SEP 2012
Copyright © 2012 Wiley Periodicals, Inc.
Pediatric Blood & Cancer
Volume 60, Issue 2, pages 230–236, February 2013
How to Cite
Macy, M. E., Duncan, T., Whitlock, J., Hunger, S. P., Boklan, J., Narendran, A., Herzog, C., Arceci, R. J., Bagatell, R., Trippett, T., Christians, U., Rolla, K., Ivy, S. P., Gore, L. and on behalf of the Pediatric Oncology Experimental Therapeutics Investigators' Consortium (POETIC) (2013), A multi-center phase Ib study of oxaliplatin (NSC#266046) in combination with fluorouracil and leucovorin in pediatric patients with advanced solid tumors. Pediatr. Blood Cancer, 60: 230–236. doi: 10.1002/pbc.24278
- Issue published online: 14 DEC 2012
- Article first published online: 28 SEP 2012
- Manuscript Accepted: 11 JUL 2012
- Manuscript Received: 31 JAN 2012
- Morgan Adams Foundation (LG)
- Alex's Lemonade Stand Foundation (LG)
- National Institutes of Health. Grant Number: K12 CA086913-08 (MEM)
- Ergen Family Chair in Pediatric Cancer (SPH)
- Phase 1
Platinum agents have been used for a variety of cancers, including pivotal use in pediatric tumors for many years. Oxaliplatin, a third generation platinum, has a different side effect profile and may provide improved activity in pediatric cancers.
Patients 21 years or younger with progressive or refractory malignant solid tumors, including tumors of the central nervous system were enrolled on this multi-center open label, non-randomized Phase 1 dose escalation study. The study used a standard 3 + 3 dose escalation design with 2 dose levels (85 and 100 mg/m2) with an expansion cohort of 15 additional patients at the recommended dose. Patients received oxaliplatin at the assigned dose level and 5-fluorouracil (5-FU) bolus 400 mg/m2 followed by a 46-hour 5-FU infusion of 2,400 mg/m2 every 14 days. The leucovorin dose was fixed at 400 mg/m2 for all cohorts.
Thirty-one evaluable patients were enrolled, 8 at 85 mg/m2 and 23 at 100 mg/m2 for a total of 121 courses. The median age was 12 years (range 2–19 years). The main toxicities were hematologic, primarily neutrophils and platelets. The most common non-hematologic toxicities were gastrointestinal. Stable disease was noted in 11 patients (54% of evaluable patients) and 1 confirmed partial response in a patient with osteosarcoma.
The maximum planned dose of oxaliplatin at 100 mg/m2 per dose in combination with 5-FU and leucovorin was safe and well tolerated and in this patient population. This combination demonstrated modest activity in patients with refractory or relapsed solid tumor and warrants further study. Pediatr Blood Cancer 2013;60:230–236. © 2012 Wiley Periodicals, Inc.