Long-Term Survival Following a Phase I/II Trial With VETOPEC for Solid Tumors in Childhood

The objective of this study was to evaluate long-term survival after treatment during a phase I/II trial with a specific regimen of vincristine, etoposide, and escalating cyclophosphamide (VETOPEC). Fifty-six children with poor-prognosis solid tumors were enrolled on study between May 1991 and May 1994. All had tumors that had relapsed on, or were refractory to, conventional treatment, or for whom existing treatment options were considered ineffective. The records of all surviving patients were reviewed to ascertain their disease and health status. Of the 56 patients, 10 patients (18%) remain alive with no further disease progression at a median follow-up of 11 years (range 7-13 years). Eight patients (14%) remain completely free of disease. None of the patients show long-term side effects directly attributable to the VETOPEC regimen, apart from one patient with ovarian failure. The VETOPEC regimen can offer not only good tumor responses but also the chance of cure for a surprisingly large number of children with very-poor-prognosis solid tumors. This regimen warrants continuing development and consideration for use in future trials.

[1]  R. Krance,et al.  Feasibility of four consecutive high-dose chemotherapy cycles with stem-cell rescue for patients with newly diagnosed medulloblastoma or supratentorial primitive neuroectodermal tumor after craniospinal radiotherapy: results of a collaborative study. , 2001, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[2]  M. Bernstein,et al.  Phase I Therapy Trials in Children With Cancer , 1998, Journal of pediatric hematology/oncology.

[3]  G. McCowage,et al.  A dose‐intensive, cyclophosphamide‐based regimen for the treatment of recurrent/Progressive or advanced solid tumors of childhood , 1997, Cancer.

[4]  J. Shuster,et al.  Pediatric Phase II Cancer Chemotherapy Trials: A Pediatric Oncology Group Study , 1997, Journal of pediatric hematology/oncology.

[5]  R. Seshadri,et al.  Dose-intensive cyclophosphamide with etoposide and vincristine for pediatric solid tumors: a phase I/II pilot study by the Australia and New Zealand Childhood Cancer Study Group. , 1994, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  J. Graham-Pole,et al.  Response of osteogenic sarcoma to the combination of etoposide and cyclophosphamide as neoadjuvant chemotherapy , 1990, Cancer.

[7]  D. Bigner,et al.  Synergistic interactions between cyclophosphamide or melphalan and VP-16 in a human rhabdomyosarcoma xenograft. , 1990, Cancer research.

[8]  T. Spitzer,et al.  Escalating doses of etoposide with cyclophosphamide and fractionated total body irradiation or busulfan as conditioning for bone marrow transplantation. , 1989, Bone marrow transplantation.

[9]  N. Breslow,et al.  Prognostic factors for children with recurrent Wilms' tumor: results from the Second and Third National Wilms' Tumor Study. , 1989, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[10]  R. Sylvester,et al.  Cyclophosphamide versus ifosfamide: final report of a randomized phase II trial in adult soft tissue sarcomas. , 1987, European journal of cancer & clinical oncology.

[11]  W. J. Oakes,et al.  Efficacy of vincristine and cyclophosphamide in the therapy of recurrent medulloblastoma. , 1986, Neurosurgery.

[12]  A. Look,et al.  Cyclophosphamide/etoposide: effective reinduction therapy for children with acute nonlymphocytic leukemia in relapse. , 1985, Cancer treatment reports.

[13]  L. Helson,et al.  High-dose cyclophosphamide chemotherapy for recurrent CNS tumors in children. , 1981, Journal of neurosurgery.

[14]  J. Holland,et al.  Effect of vincristine (NSC-67574) on malignant solid tumors in children. , 1968, Cancer chemotherapy reports.