5 Here, we report the results of the new therapeutic strategy for stage II to IV DAWT. AREN0321 also used a higher radiation dose to the flank for local stage III DAWT, because 46% of the recurrences in NWTS-5 were local. On the basis of this rationale, the Children’s Oncology Group (COG) AREN0321 study evaluated the antitumor activity of the vincristine and irinotecan (VI) combination in a phase II window in patients with newly diagnosed stage IV DAWT and whether an intensive regimen containing carboplatin in addition to the regimen I agents would improve event-free survival (EFS) or overall survival (OS) for patients with stage II to IV DAWT.
The combination of camptothecins with vincristine resulted in greater-than-additive antitumor effect. 11, 12 Irinotecan had similar activity to topotecan in patient-derived xenograft models and has less hematologic toxicity. Preclinical and early-phase clinical data showed promising antitumor activity of topotecan in WT. 6, 7 The combination of ifosfamide, carboplatin, and etoposide has also demonstrated significant activity against WT. Previous phase II studies of carboplatin as a single agent and in combination with etoposide for relapsed or refractory WT showed objective response rates of 53% and 73%, respectively. The progressive improvement in outcomes for patients with DAWT with additional chemotherapy agents suggested that additional gains may be achieved with continued augmentation of therapy.
Aren0321 qarc plus#
1 In NWTS-5, therapy was further increased using a regimen of vincristine, doxorubicin, and cyclophosphamide alternating with cyclophosphamide plus etoposide for 24 weeks plus radiotherapy (regimen I), resulting in additional improvement in patient outcomes. The 4‐year relapse-free survival (RFS) estimates for those with stage II, III, or IV DAWT treated without cyclophosphamide were 40.0%, 33.3%, and 0%, respectively, compared with 71.6%, 58.7%, and 16.7%, respectively, with cyclophosphamide. 1- 4 In the National Wilms Tumor Study 3 (NWTS-3) and NWTS-4, patients with stage II to IV diffuse anaplastic histology WT (DAWT) were treated with vincristine, dactinomycin, and doxorubicin with or without cyclophosphamide. Edward Hébert School of Medicine, Uniformed Services University, Bethesda, MDġ0Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canadaġ1Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TXġ2University of Tennessee College of Medicine–Chattanooga, Chattanooga, TNġ3Department of Pharmaceutical Services, St Jude Children’s Research Hospital, Memphis, TNġ4University of Nebraska Medical Center, Omaha, NEġ5Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, MOġ6Departments of Pediatrics and Bioethics, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canadaġ7Division of Oncology, Children’s National Medical Center, Center for Cancer and Blood Disorders, George Washington University School of Medicine and Health Sciences, Washington, DCĪnaplasia is present in 7.5% of Wilms tumors (WTs) and carries an adverse prognosis. Mott Children’s Hospital, University of Michigan, Ann Arbor, MIĨDepartment of Pediatric Hematology/Oncology, Dana-Farber/Harvard Cancer Center, Dana-Farber Cancer Institute, Boston, MAĩDepartment of Pediatrics, F.
Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, ILħDepartment of Pediatric Surgery, C.S. Lurie Children’s Hospital of Chicago, Northwestern Memorial Hospital, Chicago, ILĤDepartment of Radiology, University of Washington, Seattle, WAĥDivision of Oncology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, OHĦDepartment of Pathology, Ann and Robert H. 1Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TXĢDepartment of Biostatistics, University of Florida, Gainesville, FLģDepartment of Radiation Oncology, Ann and Robert H.
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