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Sorafenib and cisplatin/doxorubicin (PLADO) in pediatric hepatocellular carcinoma

Identifieur interne : 001159 ( Istex/Curation ); précédent : 001158; suivant : 001160

Sorafenib and cisplatin/doxorubicin (PLADO) in pediatric hepatocellular carcinoma

Auteurs : Irene Schmid [Allemagne] ; Beate H Berle [Allemagne] ; Michael H. Albert [Allemagne] ; Selim Corbacioglu [Allemagne] ; Birgit Fröhlich [Allemagne] ; Norbert Graf [Allemagne] ; Birgit Kammer [Allemagne] ; Udo Kontny [Allemagne] ; Ivo Leuschner [Allemagne] ; Hans-Gerhard Scheel-Walter [Allemagne] ; Wolfram Scheurlen [Allemagne] ; Sebastian Werner [Allemagne] ; Thomas Wiesel [Allemagne] ; Dietrich Von Schweinitz [Allemagne]

Source :

RBID : ISTEX:B1DB2E9C22FA7E49F711EDDE6F5A1E3BA0F9FE39

English descriptors

Abstract

Overall survival is poor in children with primary unresectable hepatocellular carcinoma. Sorafenib has been shown to significantly improve progression‐free survival in adult hepatocellular carcinoma (HCC) patients. We evaluated the experience of PLADO (cisplatin 80 mg/m2/day, doxorubicin 2 × 30 mg/m2/day) in combination with sorafenib in pediatric HCC patients.
Clinical data of 12 patients (7–16 years), 7 with unresectable tumor, were retrospectively assessed.
In total 6/12 (50%) patients are in complete remission after a median follow‐up of 20 months (4 with PLADO/sorafenib/resection, 2 with liver transplantation after local relapse). Of the seven patients with unresectable tumor, PLADO/sorafenib resulted in partial response (PR) in four, stable disease (SD) in two, and progression in one. Three are alive in CR after complete resection after 12 (alternative therapy after two cycles PLADO/sorafenib), 12 and 18 months (six cycles PLADO/sorafenib), respectively. All four patients with elevated alpha‐fetoprotein levels had a marked drop after two cycles. Of the five patients with primary complete tumor resection one is alive disease‐free at 27 months. Four had local or metastatic relapses (13, 7, 12, and 13 months), two of whom were rescued by liver transplantation (CR after 25 and 32 months). The main toxicity attributable to sorafenib was a hand–foot skin reaction (HFSR) in seven patients.
Sorafenib in combination with PLADO may be a promising approach in pediatric HCC; HFSR was the most important toxicity. Data based on prospective studies are needed to evaluate pharmacokinetics, resectability rates, and survival in pediatric HCC treated with sorafenib. Pediatr Blood Cancer 2012; 58: 539–544. © 2011 Wiley Periodicals, Inc.

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DOI: 10.1002/pbc.23295

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<name sortKey="Kontny, Udo" sort="Kontny, Udo" uniqKey="Kontny U" first="Udo" last="Kontny">Udo Kontny</name>
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<title level="j">Pediatric Blood & Cancer</title>
<title level="j" type="abbrev">Pediatr. Blood Cancer</title>
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<term>PLADO</term>
<term>cisplatin</term>
<term>doxorubicin</term>
<term>hepatocellular carcinoma</term>
<term>pediatric</term>
<term>sorafenib</term>
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<term>Adult patients</term>
<term>Carcinoma</term>
<term>Chemotherapy</term>
<term>Cisplatin</term>
<term>Clin oncol</term>
<term>Combination therapy</term>
<term>Complete remission</term>
<term>Complete resection</term>
<term>Diff</term>
<term>Doxorubicin</term>
<term>Hematology</term>
<term>Hepatocellular</term>
<term>Hepatocellular carcinoma</term>
<term>Hfsr</term>
<term>Hfsr grade</term>
<term>Imaging modalities</term>
<term>Imaging studies</term>
<term>Important toxicity</term>
<term>International society</term>
<term>Liver transplantation</term>
<term>Local relapse</term>
<term>Median</term>
<term>Metastatic</term>
<term>Metastatic disease</term>
<term>Multifocal</term>
<term>Oncol</term>
<term>Oncology</term>
<term>Partial response</term>
<term>Pediatr</term>
<term>Pediatr blood cancer</term>
<term>Pediatr oncol</term>
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<term>Recist criteria</term>
<term>Relapse</term>
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<term>Tumor progression</term>
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<front>
<div type="abstract">Overall survival is poor in children with primary unresectable hepatocellular carcinoma. Sorafenib has been shown to significantly improve progression‐free survival in adult hepatocellular carcinoma (HCC) patients. We evaluated the experience of PLADO (cisplatin 80 mg/m2/day, doxorubicin 2 × 30 mg/m2/day) in combination with sorafenib in pediatric HCC patients.</div>
<div type="abstract">Clinical data of 12 patients (7–16 years), 7 with unresectable tumor, were retrospectively assessed.</div>
<div type="abstract">In total 6/12 (50%) patients are in complete remission after a median follow‐up of 20 months (4 with PLADO/sorafenib/resection, 2 with liver transplantation after local relapse). Of the seven patients with unresectable tumor, PLADO/sorafenib resulted in partial response (PR) in four, stable disease (SD) in two, and progression in one. Three are alive in CR after complete resection after 12 (alternative therapy after two cycles PLADO/sorafenib), 12 and 18 months (six cycles PLADO/sorafenib), respectively. All four patients with elevated alpha‐fetoprotein levels had a marked drop after two cycles. Of the five patients with primary complete tumor resection one is alive disease‐free at 27 months. Four had local or metastatic relapses (13, 7, 12, and 13 months), two of whom were rescued by liver transplantation (CR after 25 and 32 months). The main toxicity attributable to sorafenib was a hand–foot skin reaction (HFSR) in seven patients.</div>
<div type="abstract">Sorafenib in combination with PLADO may be a promising approach in pediatric HCC; HFSR was the most important toxicity. Data based on prospective studies are needed to evaluate pharmacokinetics, resectability rates, and survival in pediatric HCC treated with sorafenib. Pediatr Blood Cancer 2012; 58: 539–544. © 2011 Wiley Periodicals, Inc.</div>
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