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Tuesday 06 November 2007

Prolonged Response to Oral Gefitinib, Cyclophophamide, and Topotecan in Heavily Pretreated Relapsed Stage 4 Neuroblastoma: A Case Report.

By: Donfrancesco A, Jenkner A, De Ioris MA, Ilari I, Castellano A, De Laurentis C, Garganese MC, Milano GM, Dominici C.

J Pediatr Hematol Oncol 2007 Nov;29(11):799-803

A girl with metastatic neuroblastoma diagnosed at 4 years of age experienced an early disseminated relapse after high-dose chemotherapy. After reinduction, compassionate treatment with gefitinib (250 mg/d fixed dose) with oral topotecan (0.8 mg/m/d) and cyclophosphamide (50 mg/m/d) for 14 consecutive days, each course repeated every 28 days, was administered. Complete marrow clearance and metaiodobenzylguanidine response were achieved after 4 courses. After the first course, topotecan and cyclophosphamide were reduced by 25% for grade 4 hematologic toxicity. Subsequent courses were well tolerated. The girl remained progression free for 27 months. This combination may represent a viable therapeutic option and deserves further evaluation in resistant neuroblastoma.

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