Evaluation Of VITB Regimen In 20 Cases Of Relapsed Or Refractory Pediatric Solid Tumors

Background:Even though the survival rate of children with malignant solid tumors has increased,the prognosis for those who suffer disease relapse and/or refractory tumors remains dismal.Given the proved effectiveness and safety of anti-angiogenesis agents,attention has been drawn to the strategy of adding such medicine to the pre-existing regimen,whose tolerance has been testified in many phase1/2 clinical trails.Methods:The subject has to be confirmed with the histological diagnose of refractory or recurrent solid tumor with the age range between 2-14.We setup the cutoff point of our research as either the completion of entire 12 rounds of chemotherapy cycle,or before the date of December 31 th,2018.The regimen is as following: vincristine 1.5mg / m2 on day1 and day8;bevacizumab 15mg/kg on the first day;irinotecan and temozolomide 100 mg / m2 through day 1-5.Results:20 patients in total were included to our research until December 31 th,2018,with the age median 8(3-13).Among them,14 are male and 8 are female.20 patients were eligible for the evaluation for the therapeutic effect and toxicity.The objective response rate(ORR,CR+PR)was 35%,and the disease control rate(DCR,CR+PR+SD)was 70%.The median progression-free survival(PFS)of all patients was 153 days(95% confidence interval or CI,4-252+),and the median overall survival(OS)was 183 days(95% CI,23-252+).Till now,9 patients are still receiving medical care,and 11 patients already deceased.The median number of chemotherapy cycle is 6.5(1-12),with 144 cycles of regimen were administered at last,during which,the most common adverse effect is gastroenteric reaction and bone marrow suppression and the incidence of 3 or 4 grade toxicity is 16.7%.Conclusions:Our manuscript demonstrates certain therapeutic effect of VITB regimen,especially in the treatment of Wilms tumor.It has been well-tolerated in Chinese children patients,therefore further exploration of this regimen is justified.Our research also provides with instruction and reference for other investigation regarding addition of other anti-angiogenesis agents to the VOTI regimen.