Feasibility of dose‐dense cisplatin‐based chemotherapy in Japanese children with high‐risk hepatoblastoma: Analysis of the JPLT3‐H pilot study. Issue 2 (4th October 2021)

• Record Type: Journal Article
• Authors: Watanabe, Kenichiro; Mori, Makiko; Hishiki, Tomoro; Yokoi, Akiko; Ida, Kohmei; Yano, Michihiro; Fujimura, Junya; Nogami, Yuki; Iehara, Tomoko; Hoshino, Ken; Inoue, Takeshi; Tanaka, Yukichi; Miyazaki, Osamu; Takimoto, Tetsuya; Yoshimura, Kenichi; Hiyama, Eiso
• Is Part Of: Pediatric blood & cancer. Volume 69:Issue 2(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2021-10-04
• Subjects: children -- cisplatin -- hepatoblastoma -- toxicity; Tumors in children -- Periodicals; Blood -- Diseases -- Periodicals; Cancer in children -- Periodicals; 618.92
• DOI: 10.1002/pbc.29389
• Languages: English
• ISSNs: 1545-5009

Abstract

Abstract: Background: The SIOPEL‐4 study has demonstrated that dose‐dense cisplatin‐based chemotherapy dramatically improves outcome in children with high‐risk hepatoblastoma in western countries. However, the feasibility and safety of this regimen have not been clarified in Japanese patients. Methods: A pilot study, JPLT3‐H, was designed to evaluate the safety profile of the SIOPEL‐4 regimen in Japanese children with newly diagnosed hepatoblastoma with either metastatic disease or low alpha‐fetoprotein. Results: A total of 15 patients (three female) were enrolled. Median age was 2 years (range, 0–14). Three patients were PRETEXT II (where PRETEXT is PRETreatment EXTent of disease), six PRETEXT III, and six PRETEXT IV. All patients had lung metastasis, none had low alpha‐fetoprotein. Eight patients completed the prescribed treatment, and seven patients discontinued therapy prematurely, four due to progressive disease and three due to causes other than severe toxicity. Grade 4 neutropenia was documented in most patients in preoperative cycles A1‐3 (11/15 in A1, 9/11 in A2, and 7/11 in A3) and in all considering all cycles. Grade 3–4 thrombocytopenia and grade 3 anemia were also frequently observed. Patients experienced several episodes of grade 3 febrile neutropenia, but none had grade 4 febrile neutropenia or severe infections. One patient had grade 3 heart failure only in the first cycle. Other grade 3 or 4 toxicities were hypomagnesemia, anorexia, nausea, mucositis, liver enzyme elevation, fever, infection, and fatigue. There were no unexpected severe toxicities. Conclusion: The toxicity profile of JPLT3‐H was comparable to that of SIOPEL‐4. Dose‐dense cisplatin‐based chemotherapy may be feasible among Japanese patients with high‐risk hepatoblastoma.