Abstract
BACKGROUND
The management of progressive unresectable low-grade glioma (PULGG) remains controversial. Some series suggests that chemotherapy may delay or even avoid radiotherapy and/or surgery in a proportion of children. Within this context we performed initially an institutional protocol with .8IV vinorelbine, a semi-synthetic vinca alkaloid that shown activity against PULGG. The objective of this study is to evaluate the response as long as the tolerability of oral vinorelbine in patients with diagnosis of optic pathway glioma (OPG). PATIENTS AND
METHODS
Since 2013, 16 patients with recurrent (n=4) and newly-diagnosed (n=12) OPG have been treat with oral vinorelbine in a dose of 90 mg/m2 days 0, 8 and 22 for 18 cycles. Response criteria used a combination of magnetic resonance imaging, physical and visual evaluation.
RESULTS
Mean age 8.6 years (4.8-17.9). Three children with neurofibromatosis type 1. Eleven patients had neurosurgical intervention revealing grade I (n=9) and grade II astrocytoma (n=2). Eleven patients were assessable after 4/8 cycles of vinorelbine with 2 objective response (OR), 7 stable disease (SD) and 2 progressive disease (PD), one died after surgery and 1 alive in different protocol. After 18 cycles, seven patients were assessable to date for response with 2 OR, 5 SD. The most important toxicity was gastrointestinal observed in 12 patients- six of them withdraw treatment. None of the patients showed neurotoxicity.
CONCLUSION
The preliminary results suggest that oral vinorelbine may show some activity in PULGG. However, gastrointestinal toxicity should be considered.