Cyclophosphamide for the treatment of progressive low-grade astrocytoma: Apediatric oncology group phase II study

Purpose: Results of a phase IT trial of cyclophosphamide (CPM), for childre n with progressive low-grade astrocytoma are reported. Patients and Methods: Fifteen patients with a median age of 39 months (rang e, 2 to 71) were included in this study. The tumors of 11 children were loc ated in the optic pathway, hypothalamus, or thalamus. Four courses of intra venous CPM 1.2 g/m(2) were administered every 3 weeks during the upfront wi ndow portion of this protocol. Subsequently, chemotherapy was to continue w ith CPM, II vincristine, and carboplatin for 2 years. Results: By study design, the first 14 patients were centrally reviewed aft er completion of the initial 3 CPM courses. Toxicity was primarily hematolo gic. One patients had a complete response, 8 had stable disease, and 5 had progressive disease (PD). The excessive number of children with PD prompted study closure. Conclusion: CPM as used in this protocol showed insufficient activity again st astrocytoma to justify further patient accrual.