Outcome of children with relapsed or refractory neuroblastoma: A meta-analysis of ITCC/SIOPEN European phase II clinical trials

Lucas Moreno, Herve Rubie, Amalia Varo, Marie Cecile Le Deley, Loredana Amoroso, Aurelie Chevance, Alberto Garaventa, Marion Gambart, Francisco Bautista, Dominique Valteau-Couanet, Birgit Geoerger, Gilles Vassal, Xavier Paoletti, Andrew D J Pearson

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Few randomized trials have been conducted in children with relapsed/refractory neuroblastoma and data about outcomes including progression-free survival (PFS) in these patients are scarce.

PROCEDURE: A meta-analysis of three phase II studies of children with relapsed/refractory neuroblastoma conducted in Europe (temozolomide, topotecan-vincristine-doxorubicin and topotecan-temozolomide) was performed. Individual patient data with extended follow-up were collected from the trial databases after publication to describe trial outcomes (response rate, clinical benefit ratio, duration of treatment, PFS, and overall survival [OS]). Characteristics of subjects with relapsed/refractory neuroblastoma were compared.

RESULTS: Data from 71 children and adolescents with relapsed/refractory neuroblastoma were collected. Response definitions were not homogeneous in the three trials. Patients were on study for a median of 3.5 months (interquartile range [IQR] 1.9-6.2). Of those, 35.2% achieved a complete or partial response, 26.3% experienced a response after more than two cycles, and 23.9% received more than six cycles. Median PFS from study entry for all, refractory, and relapsed patients was 6.4 ± 1.0, 12.5 ± 6.8, and 5.7 ± 1.0 months, respectively (P = 0.006). Median OS from study entry for all, refractory, and relapsed patients was 16.1 ± 4.3, 27.9 ± 20.2, and 11.0 ± 1.6 months, respectively (P = 0.03).

CONCLUSIONS: Baseline data for response rate, clinical benefit ratio, duration of treatment, PFS, and OS were provided. Two subpopulations (relapsed/refractory) were clearly distinct and should be included in the interpretation of all trials. These results should help informing the design of forthcoming studies in relapsed/refractory neuroblastoma.

Original languageEnglish
Pages (from-to)25-31
Number of pages7
JournalPediatric Blood and Cancer
Volume64
Issue number1
DOIs
Publication statusPublished - Jan 2017

Keywords

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols
  • Child
  • Child, Preschool
  • Clinical Trials, Phase II as Topic
  • Dacarbazine
  • Doxorubicin
  • Drug Resistance, Neoplasm
  • Europe
  • Female
  • Humans
  • Infant
  • Male
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Neuroblastoma
  • Prognosis
  • Salvage Therapy
  • Survival Rate
  • Topotecan
  • Vincristine
  • Journal Article
  • Meta-Analysis

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