1. Venetoclax plus cyclophosphamide and topotecan in heavily pre-treated relapsed metastatic neuroblastoma: a single center case series.
- Author
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De Ioris MA, Fabozzi F, Del Bufalo F, Del Baldo G, Villani MF, Cefalo MG, Garganese MC, Stracuzzi A, Tangari F, Greco AM, Giovannoni I, Carta R, D'Andrea ML, Mastronuzzi A, and Locatelli F
- Subjects
- Child, Humans, Animals, Mice, Topotecan, Neoplasm Recurrence, Local etiology, Cyclophosphamide therapeutic use, Bridged Bicyclo Compounds, Heterocyclic therapeutic use, Proto-Oncogene Proteins c-bcl-2 genetics, Chronic Disease, Antineoplastic Combined Chemotherapy Protocols adverse effects, Neuroblastoma pathology, Neoplasms, Second Primary etiology
- Abstract
The prognosis of relapsed/refractory (R/R) neuroblastoma (NB) is dismal, calling for new therapeutic strategies. Venetoclax (VEN) is a highly selective, potent, orally bioavailable, BCL-2 inhibitor small-molecule that showed a synergistic effect with cyclophosphamide and topotecan (Cy-Topo) in murine NB models. Our aim was to evaluate the feasibility of VEN plus Cy-Topo in children with R/R NB. Four patients, who had previously failed > 3 lines of treatment, were treated with VEN plus Cy-Topo based on a 28-day schedule in an outpatient setting. BCL-2 expression in immunochemistry on tumor samples at relapse and the BCL2 gene status was evaluated in all patients. The main toxicity was hematological, with grade 4 neutropenia and thrombocytopenia occurring in all courses and leading to transient VEN discontinuation. Grade 3 oral mucositis was observed in 1/8 courses. No other grade 2-4 toxicities were observed. BCL-2 was expressed in all tumors, while no molecular abnormalities in the BCL-2 genes were detected. A stable disease was observed in all patients, without any progression during the study period. VEN plus Cy-Topo is well tolerated, with encouraging results that may be improved by testing the schedule in less advanced patients., (© 2023. The Author(s).)
- Published
- 2023
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