Carboplatin and vincristine neurotoxicity in the treatment of pediatric low‐grade gliomas

Rosca, Lorena; Robert-Boire, Viviane; Delisle, Jean-François; Samson, Yvan; Perreault, Sébastien

doi:10.1002/pbc.27351

Cited by 21 publications

(15 citation statements)

References 21 publications

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“…It usually starts after a few administrations and symptoms often reside several months after treatment cessation [1,2]. VIPN can lead to suboptimal treatment due to dose reductions or omissions of VCR [10,13]. VIPN is dose-dependent, with single administration doses exceeding 2.0 mg/m 2 leading to intolerable VIPN in children [14].…”

Section: Introductionmentioning

confidence: 99%

Vincristine-Induced Peripheral Neuropathy in Pediatric Oncology: A Randomized Controlled Trial Comparing Push Injections with One-Hour Infusions (The VINCA Trial)

Velde

Kaspers

Abbink

et al. 2020

Cancers

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Vincristine (VCR) is a frequently used chemotherapeutic agent. However, it can lead to VCR-induced peripheral neuropathy (VIPN). In this study we investigated if one-hour infusions of VCR instead of push-injections reduces VIPN in pediatric oncology patients. We conducted a multicenter randomized controlled trial in which participants received all VCR administrations through push injections or one-hour infusions. VIPN was measured at baseline and 1–5 times during treatment using Common Terminology Criteria of Adverse Events (CTCAE) and pediatric-modified Total Neuropathy Score. Moreover, data on co-medication, such as azole antifungals, were collected. Overall, results showed no effect of administration duration on total CTCAE score or ped-mTNS score. However, total CTCAE score was significantly lower in patients receiving one-hour infusions concurrently treated with azole antifungal therapy (β = -1.58; p = 0.04). In conclusion, generally VCR administration through one-hour infusions does not lead to less VIPN compared to VCR push injections in pediatric oncology patients. However, one-hour infusions lead to less severe VIPN compared to push-injections when azole therapy is administered concurrently with VCR. These results indicate that in children treated with VCR and requiring concurrent azole therapy, one-hour infusions might be beneficial over push injections, although larger trials are needed to confirm this association.

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Section: Introductionmentioning

confidence: 99%

Vincristine-Induced Peripheral Neuropathy in Pediatric Oncology: A Randomized Controlled Trial Comparing Push Injections with One-Hour Infusions (The VINCA Trial)

Velde

Kaspers

Abbink

et al. 2020

Cancers

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“…In their retrospective study among children with low-grade gliomas treated with carboplatin and vincristine, Rosca et al demonstrated that VIPN is more developed during the induction phase, when the administrations of vincristine are more closely, suggesting an association between the increased risk of VIPN and the intensity of vincristine infusion [ 57 ]. Regarding the duration of vincristine administration, currently, bolus injections over 1–5 min are the standard for pediatric protocols.…”

Section: Treatment-related Risk Factors For Vipnmentioning

confidence: 99%

Vincristine-Induced Peripheral Neuropathy (VIPN) in Pediatric Tumors: Mechanisms, Risk Factors, Strategies of Prevention and Treatment

Triarico

Romano

Attinà

et al. 2021

IJMS

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Vincristine-induced peripheral neurotoxicity (VIPN) is a very common side effect of vincristine chemotherapy among pediatric patients with cancer. Neuropathy may be sensory, motor and/or autonomic, with consequent reduction, delay or discontinuation of vincristine-chemotherapy, but also pain, disability, reduced quality of life of patients and an increase in medical costs. Vincristine acts out its antineoplastic function by altering the normal assembly and disassembly of microtubules, with their consequent mitosis block and death. Vincristine leads to VIPN through a complex mechanism of damage, which occurs not only on the microtubules, but also on the endothelium and the mitochondria of nerve cells. Furthermore, both patient-related risk factors (age, race, ethnicity and genetic polymorphisms) and treatment-related risk factors (dose, time of infusion and drug–drug interactions) are involved in the pathogenesis of VIPN. There is a lack of consensus about the prophylaxis and treatment of VIPN among pediatric oncologic patients, despite several molecules (such as gabapentin, pyridoxine and pyridostigmine, glutamic acid and glutamine) having been already investigated in clinical trials. This review describes the molecular mechanisms of VIPN and analyzes the risk factors and the principal drugs adopted for the prophylaxis and treatment of VIPN in pediatric patients with cancer.

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“…Children with recurrent tumors, radiographic growth of remaining tumors, or tumors in unfavorable locations inaccessible to future surgery, are advised to undergo adjuvant treatment [35]. Chemotherapy is the first-line adjuvant therapy and preferred over radiotherapy (RT) [35,57,58]. Few trials regarding different chemotherapy regiments exist [35,51,52,57,59,60] (Table 2).…”

Section: Adjuvant Therapymentioning

confidence: 99%

“…Chemotherapy is the first-line adjuvant therapy and preferred over radiotherapy (RT) [35,57,58]. Few trials regarding different chemotherapy regiments exist [35,51,52,57,59,60] (Table 2). Children with neurofibromatosis type 1 (NF-1) and associated pLGG showed a much higher response to chemotherapy (carboplatin, vincristine) with a PFS of 69% compared to 39% for the remaining pLGG [61].…”

Section: Adjuvant Therapymentioning

confidence: 99%

Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?

2021

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Two thirds of pediatric gliomas are classified as low-grade (LGG), while in adults only around 20% of gliomas are low-grade. However, these tumors do not only differ in their incidence but also in their location, behavior and, subsequently, treatment. Pediatric LGG constitute 65% of pilocytic astrocytomas, while in adults the most commonly found histology is diffuse low-grade glioma (WHO II), which mostly occurs in eloquent regions of the brain, while its pediatric counterpart is frequently found in the infratentorial compartment. The different tumor locations require different skillsets from neurosurgeons. In adult LGG, a common practice is awake surgery, which is rarely performed on children. On the other hand, pediatric neurosurgeons are more commonly confronted with infratentorial tumors causing hydrocephalus, which more often require endoscopic or shunt procedures to restore the cerebrospinal fluid flow. In adult and pediatric LGG surgery, gross total excision is the primary treatment strategy. Only tumor recurrences or progression warrant adjuvant therapy with either chemo- or radiotherapy. In pediatric LGG, MEK inhibitors have shown promising initial results in treating recurrent LGG and several ongoing trials are investigating their role and safety. Moreover, predisposition syndromes, such as neurofibromatosis or tuberous sclerosis complex, can increase the risk of developing LGG in children, while in adults, usually no tumor growth in these syndromes is observed. In this review, we discuss and compare the differences between pediatric and adult LGG, emphasizing that pediatric LGG should not be approached and managed in the same way as adult LCG.

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Carboplatin and vincristine neurotoxicity in the treatment of pediatric low‐grade gliomas

Cited by 21 publications

References 21 publications

Vincristine-Induced Peripheral Neuropathy in Pediatric Oncology: A Randomized Controlled Trial Comparing Push Injections with One-Hour Infusions (The VINCA Trial)

Vincristine-Induced Peripheral Neuropathy in Pediatric Oncology: A Randomized Controlled Trial Comparing Push Injections with One-Hour Infusions (The VINCA Trial)

Vincristine-Induced Peripheral Neuropathy (VIPN) in Pediatric Tumors: Mechanisms, Risk Factors, Strategies of Prevention and Treatment

Pediatric and Adult Low-Grade Gliomas: Where Do the Differences Lie?

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