title: Oxaliplatin and Doxorubicin for relapsed or refractory high-risk neuroblastoma.
abstract: Patients with relapsed or refractory neuroblastoma have poor long-term survival. New therapeutic regimens are needed. Doxorubicin and cisplatin are commonly used in the treatment of high-risk neuroblastoma. Oxaliplatin, a platinum compound with a 1,2-diaminocyclohexan carrier ligand, is more potent than cisplatin with less nephrotoxicity and ototoxicity. We treated seven relapsed/refractory neuroblastoma patients using oxaliplatin (105-130 mg/m(2)) and doxorubicin (60-75 mg/m(2)) together with dexrazoxane (10 mg/mg of doxorubicin) administered intravenously every three weeks. Prolonged thrombocytopenia causing treatment delay was observed when oxaliplatin was administered at 130 mg/m(2). A reduced dose of oxaliplatin 105 mg/m(2) on day 1 with doxorubicin at 20 mg/m(2)/dose on days 1-3 was well tolerated. Sensory neuropathies were mild and transient. No cardiotoxicity was noted despite all patients having a history of prior anthracycline exposure. Best responses included 1 complete response, 1 partial response, 1 mixed response, 3 stable diseases. In our cohort of heavily pretreated relapsed and refractory neuroblastoma patients, the combination of oxaliplatin and doxorubicin demonstrated anti-tumor activity and merits further investigation.
authors.affiliation: 2Division of Hematology/Oncology/BMT, Children's Hospital Los Angeles , Los Angeles, California , USA.
authors.forename: Hung C
authors.initials: HC
authors.lastname: Tran
authors.forename: Araz
authors.initials: A
authors.lastname: Marachelian
authors.forename: Rajkumar
authors.initials: R
authors.lastname: Venkatramani
authors.forename: Rima F
authors.initials: RF
authors.lastname: Jubran
authors.forename: Leo
authors.initials: L
authors.lastname: Mascarenhas
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D009447:Neuroblastoma / Q000188:drug therapy*; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D012307:Risk Factors
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D004317:Doxorubicin
keywords: Chemotherapy; doxorubicin; neuroblastoma; oxaliplatin; pediatric oncology