Study Examines Topotecan-Based Therapy for Advanced Retinoblastoma

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Findings show globe salvage with vision for topotecan plus vincristine, carboplatin, focal therapy
Findings show globe salvage with vision for topotecan plus vincristine, carboplatin, focal therapy

HealthDay News — For patients with advanced retinoblastoma, topotecan combined with vincristine, carboplatin, and aggressive focal therapies is effective, according to a study published online October 10 in the Journal of Clinical Oncology.

Rachel C. Brennan, MD, from St. Jude Children's Research Hospital in Memphis, Tennessee, and colleagues examined topotecan-based therapy for advanced intraocular retinoblastoma in a study involving 27 patients with bilateral retinoblastoma. Patients received two courses of topotecan plus vincristine, followed by two courses of three alternating administrations of carboplatin and vincristine, and one course of topotecan plus vincristine with optional periocular carboplatin. After cycle 2, focal therapy was applied. 

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The researchers found that 11 eyes were enucleated: one at diagnosis, nine with progressive disease (thee of which were treated with external-beam radiotherapy [EBRT]), and one with neovascular glaucoma that developed post-therapy. The cumulative incidence of EBRT was 5.9% at 10 years, and event-free survival was 69.2%. Ocular survival was 77.5 percent for Reese-Ellsworth group IV to V eyes and 74.3 percent for International Classification group C to E eyes. In vision testing, one eye from 23 patients documented 20/70 vision or better, while 19 of 25 patients demonstrated 20/40 vision or better in one eye.

"Topotecan combined with vincristine, carboplatin, and aggressive focal therapies is an effective regimen for the treatment of advanced retinoblastoma and results in globe salvage with vision," the authors write.

One author disclosed financial ties to Novimmune.

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