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Reported outcomes of children with newly diagnosed high-grade gliomas treated with nimotuzumab and irinotecan

Abstract

Purpose

The outcome of children with high-grade gliomas (HGGs) treated with radiation and adjuvant chemotherapy remains poor. The expression of epidermal growth factor receptor (EGFR) has been established in children with HGGs. This report demonstrated the outcomes of adjuvant nimotuzumab, an EGFR inhibitor, with irinotecan in pediatric HGGs.

Methods

Children with newly diagnosed HGGs were enrolled. Two weeks after surgery, nimotuzumab with a dose of 150 mg/m2 was given every week during radiation. After completion of radiation, a 4-week cycle of nimotuzumab (150 mg/m2) at week 1 and 3 and irinotecan (125 mg/m2) at week 1, 2, and 3 was given.

Results

Sixteen patients (5 females, 11 males), with a mean ± SD age of 8.2 ± 3.5 years were included. Tumors were located at the supratentorial region (50.0%), infratentorial region (43.8%), and both locations (6.2%). The 5-year PFS and OS were 19.9 ± 11.6 and 31.5 ± 13.0%, respectively. Median times of PFS and OS were 1.8 and 1.9 years, respectively. Prognostic factors related to good outcome were the location of tumor at the supratentorial region or outside brainstem and the extension of surgery. Side effects were minimal, with grade 1 anemia in three patients and diarrhea in one patient. Although, the adjuvant regimen of nimotuzumab and irinotecan slightly increases the overall outcome when compared to the historical study, the advantages of this protocol were minimal side effect, short period of hospitalization, and improved OS in patients who received extensive surgery.

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Acknowledgements

The authors thank other physicians including Samart Pakakasama MD, Ake Hansasuta MD, Usanarat Anurathapan MD, Watinee Sanpote MD, Surapong Lertthammakiat MD, Peerapong Lueangapapong MD, Artit Jinawath MD and Noppadol Larbcharoensub MD, and paramedical personnel who have been involved in patient treatment and funding support from the Cancer Center of Faculty of Medicine Ramathibodi Hospital. Nongnuch Sirachainan is a recipient of the Career Development Award from the Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok.

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Correspondence to Suradej Hongeng.

Ethics declarations

This study was conducted between May 1, 2010 and January 1, 2016, and approved by the Institutional Review Board.

Conflict of interest

The authors indicated no potential conflicts of interest.

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Sirachainan, N., Boongird, A., Swangsilpa, T. et al. Reported outcomes of children with newly diagnosed high-grade gliomas treated with nimotuzumab and irinotecan. Childs Nerv Syst 33, 893–897 (2017). https://doi.org/10.1007/s00381-017-3409-y

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Keywords

  • High-grade gliomas
  • Chemotherapy
  • Outcome
  • Nimotuzumab