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Cyclosphosphamide therapy of medulloblastoma: From the laboratory to the clinic and back again (and again and again)

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Summary

Medulloblastoma, the most common malignancy of childhood, was originally shown to be sensitive to cyclophosphamide in 1981. We have used combined laboratory and clinical investigations to demonstrate the synergy of cyclophosphamide and vincristine in the treatment of this tumor, the therapeutic gain associated with escalation of the dosage of cyclophosphamide, the consequence of and mechanisms underlying resistance of medulloblastoma to cyclophosphamide, the emerging importance of the neuroaxis as a site of relapse of medulloblastoma, and newer approaches, including intrathecal 4-hydroperoxycyclophosphamide and busulfan, to treat neuraxis disease. These studies serve as a paradigm for laboratory-clinical translational research.

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References

  1. Friedman HS, Oakes WJ, Bigner SH, Wikstrand CJ, Bigner DD: Medulloblastoma: Tumor biological and clinical perspectives. J Neurooncol 11: 1–15, 1991

    Google Scholar 

  2. Allen JC, Helson L: High-dose cyclophosphamide chemotherapy for recurrent CNS tumors in children. J Neurosurg 55: 749–756, 1981

    Google Scholar 

  3. Friedman HS, Bigner SH, McComb RD, Schold SC Jr, Pasternak JF, Groothuis DR, Bigner DD: A model for human medulloblastoma: Growth, morphology, and chromosomal analysisin vitro and in athymic mice. J Neuropathol Exp Neurol 42: 485–503, 1983

    Google Scholar 

  4. Friedman HS, Burger PC, Bigner SH, Trojanowski JW, Wikstrand CJ, Halperin EC, Bigner DD: Establishment and characterization of the human medulloblastoma cell line and transplantable xenograft D283 Med. J Neuropathol Exp Neurol 44: 592–605, 1985

    Google Scholar 

  5. Friedman HS, Burger PC, Bigner SH, Trojanowski JQ, Brodeur GM, He X, Wikstrand CJ, Kurtzberg J, Berens ME, Halperin EC, Bigner DD: Phenotypic and genotypic analysis of a human medulloblastoma cell line and transplantable xenograft (D341 Med) demonstrating amplification of c-myc. Am J Pathol 130: 472–484, 1988a

    Google Scholar 

  6. Bigner SH, Friedman HS, Vogelstein B, Oakes WJ, Bigner DD: Amplification of the c-myc gene in medulloblastoma cell lines and xenografts. Cancer Res 50: 2347–2350, 1990

    Google Scholar 

  7. Friedman HS, Colvin OM, Ludeman SM, Schold SC Jr, Boyd VL, Mulhbaier LH, Bigner DD: Experimental chemotherapy of human medulloblastoma with classical alkylators. Cancer Res 46: 2827–2833, 1986a

    Google Scholar 

  8. Friedman HS, Colvin OM, Shapek SX, Ludeman SM, Elion GB, Schold SC Jr, Jacobsen PF, Muhlbaier LH, Bigner DD: Experimental chemotherapy of human medulloblastoma cell lines and transplantable xenografts with bifunctional alkylating agents. Cancer Res 48: 4189–4195, 1988b

    Google Scholar 

  9. Friedman HS, Mahaley MS Jr, Schold SC Jr, Vick NA, Falletta JM, Bullard DE, D'Souza BJ, Khandekar JD, Lew S, Oakes WJ, Bigner DD: Efficacy of vincristine and cyclo-phosphamide in the therapy of recurrent medulloblastoma. Neurosurgery 18: 335–340, 1986b

    Google Scholar 

  10. Duffner PK, Horowitz ME, Krischer J, Friedman HS, Burger PC, Cohen ME, Sanford R, Mulhern RK, Scidel FG, Kun L: Postoperative chemotherapy and delayed radiation in children less than 3 years of age with malignant brain tumors: A pediatric oncology group study. New Engl J Med 328: 1725–1731, 1993

    Google Scholar 

  11. Mosijczuk AD, Nigro MA, Thomas PRM, Burger PC, Krischer JP, Morantz R, Mulne AF, Towbin RB, Freeman AI, Kurdunowiez B, Nigro ED, Friedman HS, Kun LE: Pre radiation chemotherapy in advanced medulloblastoma: A Pediatrie Oncology Group pilot study. Cancer 72: 2755–2762.

  12. Lachance DH, Oette D, Schold SC Jr, Brown M, Kurtzberg J, Graham ML, Tien R, Felsberg G, Colvin OM, Moghrabi A, Browning I, Hockenberger B, Stewart E, Ferrell L, Kerby T, Duncan-Brown M, Golembe B, Fuchs H, Fredericks R, Hayes FA, Rubin AS, Bigner DD, Friedman HS: Dose escalation trial of cyclophosphamide with sargramostim in the treatment of central nervous system (CNS) neoplasms. Med Pediatr Oncol 24: 241–247, 1995

    Google Scholar 

  13. Moghrabi A, Fuchs H, Brown M, Schold SC Jr, Graham M, Kurtzberg J, Tien R, Felsberg G, Lachance DH, Colvin OM, Oette D, Hockenberger B, Stewart E, Ferrell L, Kerby T, Duncan-Brown M, Bigner DD. Friedman HS: Cyclophos-phamide in combination with sargramostim for treatment of recurrent medulloblastoma. Med Pediatr Oncol, in press, 1994

  14. Friedman HS, Schold SC Jr, Mahaley MS, Colvin OM, Oakes WJ, Vick NA, Burger PC, Bigner SH, Borowitz M, Halperin EC, Djang W, Falletta JM, DeLong R, Garvin JH, DeVivo DC, Norris D, Golumbe B, Winter J, Bodziner RA, Sipahi H, Bigner DD: Phase II treatment of medulloblastoma and pineoblastoma with melphalan: Clinical therapy based on experimental models of human medulloblastoma. J Clin Oncol 7: 904–911, 1989

    Google Scholar 

  15. Mahoney D, Strother D, Bowen T, Ghim T, Pick T, Wall D, Yu L, Friedman HS: High dose melphalan (MELP) and cyclophosphamide (CTX) with autologous bone marrow rescue (ABMR) for recurrent/progressive malignant brain tumors (BT) in children: A phase I–II pediatric oncology group study (abstract). Proc Am Soc Clin Oncol 13: 174, 1994

    Google Scholar 

  16. Friedman HS, Colvin OM, Kaufmann SH, Ludeman SM, Bullock N, Bigner DD, Griffith OW: Cyclophosphamide resistance in medulloblastoma. Cancer Res 52: 5373–5378, 1992

    Google Scholar 

  17. Friedman HS, Colvin OM, Aisaka K, Popp J, Bossen EH, Reimer KA, Powell JB, Hilton J, Gross SS, Levi R, Bigner DD, Griffith OW: Glutathione protects cardiac and skeletal muscle from cyclophosphamide-induced toxicity. Cancer Res 50: 2455–2462, 1990

    Google Scholar 

  18. Colvin M, Chabner BA: Alkylator agents. In: Chabner BA, Collins JM (eds) Cancer Chemotherapy: Principles and Practice. JP Lippincott, Philadelphia, 1990, pp 276–313

    Google Scholar 

  19. Aaron RH, Elion GB, Colvin OM, Graham M, Keir S, Bigner DD, Friedman HS: Busulfan therapy of central nervous system xenografts in athymic mice. Cancer Chemother Pharmacol 35: 127–131, 1994

    Google Scholar 

  20. Fuchs HE, Archer GE, Colvin OM, Bigner SH, Schuster JM, Fuller GN, Schold SC Jr, Muhlbaier LH, Friedman HS, Bigner DD: Activity of intrathecal 4-hydroperoxycyclo-phosphamide in a nude rat model of human neoplastic meningitis. Cancer Res 50: 1954–1959, 1990

    Google Scholar 

  21. Friedman HS, Ochs J, Finlay J, Geyer R, Arndt C, Cohen B, Phillips P, Strauss LC, Hochberg F, Schold SC, Bigner DD, Colvin OM: Phase I trial of intrathecal 4-hydroperoxycyclo-phosphamide for neoplastic meningitis (abstract). Proc Am Assoc Cancer Res 34: 269, 1993

    Google Scholar 

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Friedman, H.S., Bigner, S.H. & Bigner, D.D. Cyclosphosphamide therapy of medulloblastoma: From the laboratory to the clinic and back again (and again and again). J Neuro-Oncol 24, 103–108 (1995). https://doi.org/10.1007/BF01052667

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