title: Patients in pediatric phase I and early phase II clinical oncology trials at Gustave Roussy: a 13-year center experience.
abstract: In the European Union, the pediatric medicines regulation in 2007 modified significantly the access to new agents in pediatric oncology. Early oncology trials are still thought to be associated with limited benefit and substantial risk. We report the characteristics and outcome of patients below 21 years enrolled in investigational trials in the Pediatric and Adolescent Department at Gustave Roussy between January 2000 and December 2012. A total of 235 patients (median age, 10.4 [0.8 to 20.7] y) were included in 26 trials (16 cytotoxic and 10 targeted agents) for a total of 260 inclusions. A total of 117 patients (50%) had brain tumors and 68 (29%) had various soft tissue and bone sarcoma. Thirteen of the 106 patients in a phase I trial experienced dose-limiting toxicity. Main severe toxicity was hematologic; none had toxic death. Grade 3 to 4 toxicities were associated with combination trials, cytotoxic agent, and at least 1 previous line of therapy. Thirty patients (12%) had objective response and 42 (16%) had stable disease for >4 months. Median overall survival was 9.0 months (95% CI, 7.5-10.5) and 73% of patients received further anticancer treatment. Phase I to II pediatric oncology trials are safe, associated with clinical benefit, and can be successfully integrated in current relapse strategies.
authors.affiliation: Departments of *Pediatric and Adolescent Oncology †Biostatistics and Epidemiology ‡Radiology §CNRS UMR 8203 Vectorology and Anticancer Therapeutics, Université Paris-Sud 11, Gustave Roussy, Villejuif, France.
authors.forename: Francisco
authors.initials: F
authors.lastname: Bautista
authors.forename: Angela
authors.initials: A
authors.lastname: Di Giannatale
authors.forename: Nathalie
authors.initials: N
authors.lastname: Dias-Gastellier
authors.forename: Mony
authors.initials: M
authors.lastname: Fahd
authors.forename: Dominique
authors.initials: D
authors.lastname: Valteau-Couanet
authors.forename: Dominique
authors.initials: D
authors.lastname: Couanet
authors.forename: Jacques
authors.initials: J
authors.lastname: Grill
authors.forename: Laurence
authors.initials: L
authors.lastname: Brugières
authors.forename: Christelle
authors.initials: C
authors.lastname: Dufour
authors.forename: Nathalie
authors.initials: N
authors.lastname: Gaspar
authors.forename: Véronique
authors.initials: V
authors.lastname: Minard-Colin
authors.forename: Chantal
authors.initials: C
authors.lastname: Kalifa
authors.forename: Odile
authors.initials: O
authors.lastname: Oberlin
authors.forename: Catherine
authors.initials: C
authors.lastname: Patte
authors.forename: Gilles
authors.initials: G
authors.lastname: Vassal
authors.forename: Birgit
authors.initials: B
authors.lastname: Geoerger
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015201:Meta-Analysis as Topic; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000628:therapy*; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult