Tamoxifen and carboplatin for children with low-grade gliomas: A pilot study at st. jude children’s research hospital

Andrew W. Walter, Amar Gajjar, David A. Reardon, Stephen J. Thompson, James W. Langston, Dana Jones-Wallace, Larry E. Kun, Richard L. Heideman

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23 Scopus citations

Abstract

Purpose: The authors conducted a single-arm, prospective study using tamoxifen and carboplatin for the treatment of children with progressive or symptomatic low-grade gliomas. Patients and Methods: Fourteen children with consecutively diagnosed cases of low-grade glioma were enrolled in this study; all patients were younger than 14 years. One patient was excluded after induction chemotherapy because of the diagnosis of a nonmalignant condition. Patients were treated with daily tamoxifen (20 mg/m2 administered twice per day) in addition to targeted, monthly intravenous carboplatin at an area under the curve (AUC) exposure of 6.5 mg/mL × minute for 1 year or until they had clinical or radiologic evidence of disease progression. Results: The median age at diagnosis was 5.3 years, the median age at initiation of chemotherapy was 8.3 years. Eight patients had tumors of the hypothalamus/optic pathway, two patients had thalamic tumors, and one patient each had tumors in the temporal lobe, tectum, and brain stem. Tumor histologic findings included fibrillary astrocytoma (n = 2), juvenile pilocytic astrocytoma (n = 6), and oligodendroglioma (n = 1). The best response to therapy was a partial response in two patients, stable disease in nine patients, and progressive disease in two patients. The overall survival at 3 years is 69%. The 3-year progression-free survival is 47%. Tamoxifen and carboplatin chemotherapy did not result in a significant number of objective responses in children with low-grade gliomas. The progression-free survival is similar to that of other published series. Nonmyelosuppressive agents such as tamoxifen deserve additional evaluation in the treatment of children with low-grade gliomas.

Original languageEnglish (US)
Pages (from-to)247-251
Number of pages5
JournalAmerican Journal of Pediatric Hematology/Oncology
Volume22
Issue number3
Publication statusPublished - Jan 1 2000

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Keywords

  • Brain tumors
  • Carboplatin
  • Chemotherapy
  • Children
  • Low-grade glioma
  • Tamoxifen

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Walter, A. W., Gajjar, A., Reardon, D. A., Thompson, S. J., Langston, J. W., Jones-Wallace, D., ... Heideman, R. L. (2000). Tamoxifen and carboplatin for children with low-grade gliomas: A pilot study at st. jude children’s research hospital. American Journal of Pediatric Hematology/Oncology, 22(3), 247-251.