Intrathecal treatment of neoplastic meningitis due to breast cancer with a slow-release formulation of cytarabine

Kurt Jaeckle, S. Phuphanich, M. J. Van den Bent, R. Aiken, T. Batchelor, T. Campbell, D. Fulton, M. Gilbert, D. Heros, L. Rogers, S. J. O'Day, W. Akerley, J. Allen, S. Baidas, S. Z. Gertler, H. S. Greenberg, S. LaFollette, G. Lesser, W. Mason, L. Recht & 12 others E. Wong, M. C. Chamberlain, A. Cohn, M. J. Glantz, J. C. Gutheil, B. Maria, P. Moots, P. New, C. Russell, W. Shapiro, L. Swinnen, S. B. Howell

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Depocyte is a slow-release formulation of cytarabine designed for intrathecal administration. The goal of this multi-centre cohort study was to determine the safety and efficacy of DepoCyte for the intrathecal treatment of neoplastic meningitis due to breast cancer. DepoCyte 50 mg was injected once every 2 weeks for one month of induction therapy; responding patients were treated with an additional 3 months of consolidation therapy. All patients had metastatic breast cancer and a positive CSF cytology or neurologic findings characteristic of neoplastic meningitis. The median number of DepoCyte doses was 3, and 85% of patients completed the planned 1 month induction. Median follow up is currently 19 months. The primary endpoint was response, defined as conversion of the CSF cytology from positive to negative at all sites known to be positive, and the absence of neurologic progression at the time the cytologic conversion was documented. The response rate among the 43 evaluable patients was 28% (CI 95%: 14-41%); the intent-to-treat response rate was 21% (CI 95%: 12-34%). Median time to neurologic progression was 49 days (range 1-515 +); median survival was 88 days (range 1-515 +), and 1 year survival is projected to be 19%. The major adverse events were headache and arachnoiditis. When drug-related, these were largely of low grade, transient and reversible. Headache occurred on 11% of cycles; 90% were grade 1 or 2. Arachnoiditis occurred on 19% of cycles; 88% were grade 1 or 2. DepoCyte demonstrated activity in neoplastic meningitis due to breast cancer that is comparable to results reported with conventional intrathecal agents. However, this activity was achieved with one fourth as many intrathecal injections as typically required in conventional therapy. The every 2 week dose schedule is a major advantage for both patients and physicians.

Original languageEnglish (US)
Pages (from-to)157-163
Number of pages7
JournalBritish Journal of Cancer
Volume84
Issue number2
DOIs
StatePublished - Feb 13 2001

Fingerprint

Cytarabine
Meningitis
Breast Neoplasms
Arachnoiditis
Nervous System
Headache
Cell Biology
Therapeutics
Spinal Injections
Survival
Neurologic Manifestations
Appointments and Schedules
Cohort Studies
Physicians
Safety
Pharmaceutical Preparations

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Jaeckle, K., Phuphanich, S., Van den Bent, M. J., Aiken, R., Batchelor, T., Campbell, T., ... Howell, S. B. (2001). Intrathecal treatment of neoplastic meningitis due to breast cancer with a slow-release formulation of cytarabine. British Journal of Cancer, 84(2), 157-163. https://doi.org/10.1054/bjoc.2000.1574
Jaeckle, Kurt ; Phuphanich, S. ; Van den Bent, M. J. ; Aiken, R. ; Batchelor, T. ; Campbell, T. ; Fulton, D. ; Gilbert, M. ; Heros, D. ; Rogers, L. ; O'Day, S. J. ; Akerley, W. ; Allen, J. ; Baidas, S. ; Gertler, S. Z. ; Greenberg, H. S. ; LaFollette, S. ; Lesser, G. ; Mason, W. ; Recht, L. ; Wong, E. ; Chamberlain, M. C. ; Cohn, A. ; Glantz, M. J. ; Gutheil, J. C. ; Maria, B. ; Moots, P. ; New, P. ; Russell, C. ; Shapiro, W. ; Swinnen, L. ; Howell, S. B. / Intrathecal treatment of neoplastic meningitis due to breast cancer with a slow-release formulation of cytarabine. In: British Journal of Cancer. 2001 ; Vol. 84, No. 2. pp. 157-163.
@article{8cb12f22b64a42d5875ef3dd0f68edad,
title = "Intrathecal treatment of neoplastic meningitis due to breast cancer with a slow-release formulation of cytarabine",
abstract = "Depocyte is a slow-release formulation of cytarabine designed for intrathecal administration. The goal of this multi-centre cohort study was to determine the safety and efficacy of DepoCyte for the intrathecal treatment of neoplastic meningitis due to breast cancer. DepoCyte 50 mg was injected once every 2 weeks for one month of induction therapy; responding patients were treated with an additional 3 months of consolidation therapy. All patients had metastatic breast cancer and a positive CSF cytology or neurologic findings characteristic of neoplastic meningitis. The median number of DepoCyte doses was 3, and 85{\%} of patients completed the planned 1 month induction. Median follow up is currently 19 months. The primary endpoint was response, defined as conversion of the CSF cytology from positive to negative at all sites known to be positive, and the absence of neurologic progression at the time the cytologic conversion was documented. The response rate among the 43 evaluable patients was 28{\%} (CI 95{\%}: 14-41{\%}); the intent-to-treat response rate was 21{\%} (CI 95{\%}: 12-34{\%}). Median time to neurologic progression was 49 days (range 1-515 +); median survival was 88 days (range 1-515 +), and 1 year survival is projected to be 19{\%}. The major adverse events were headache and arachnoiditis. When drug-related, these were largely of low grade, transient and reversible. Headache occurred on 11{\%} of cycles; 90{\%} were grade 1 or 2. Arachnoiditis occurred on 19{\%} of cycles; 88{\%} were grade 1 or 2. DepoCyte demonstrated activity in neoplastic meningitis due to breast cancer that is comparable to results reported with conventional intrathecal agents. However, this activity was achieved with one fourth as many intrathecal injections as typically required in conventional therapy. The every 2 week dose schedule is a major advantage for both patients and physicians.",
author = "Kurt Jaeckle and S. Phuphanich and {Van den Bent}, {M. J.} and R. Aiken and T. Batchelor and T. Campbell and D. Fulton and M. Gilbert and D. Heros and L. Rogers and O'Day, {S. J.} and W. Akerley and J. Allen and S. Baidas and Gertler, {S. Z.} and Greenberg, {H. S.} and S. LaFollette and G. Lesser and W. Mason and L. Recht and E. Wong and Chamberlain, {M. C.} and A. Cohn and Glantz, {M. J.} and Gutheil, {J. C.} and B. Maria and P. Moots and P. New and C. Russell and W. Shapiro and L. Swinnen and Howell, {S. B.}",
year = "2001",
month = "2",
day = "13",
doi = "10.1054/bjoc.2000.1574",
language = "English (US)",
volume = "84",
pages = "157--163",
journal = "British Journal of Cancer",
issn = "0007-0920",
publisher = "Nature Publishing Group",
number = "2",

}

Jaeckle, K, Phuphanich, S, Van den Bent, MJ, Aiken, R, Batchelor, T, Campbell, T, Fulton, D, Gilbert, M, Heros, D, Rogers, L, O'Day, SJ, Akerley, W, Allen, J, Baidas, S, Gertler, SZ, Greenberg, HS, LaFollette, S, Lesser, G, Mason, W, Recht, L, Wong, E, Chamberlain, MC, Cohn, A, Glantz, MJ, Gutheil, JC, Maria, B, Moots, P, New, P, Russell, C, Shapiro, W, Swinnen, L & Howell, SB 2001, 'Intrathecal treatment of neoplastic meningitis due to breast cancer with a slow-release formulation of cytarabine', British Journal of Cancer, vol. 84, no. 2, pp. 157-163. https://doi.org/10.1054/bjoc.2000.1574

Intrathecal treatment of neoplastic meningitis due to breast cancer with a slow-release formulation of cytarabine. / Jaeckle, Kurt; Phuphanich, S.; Van den Bent, M. J.; Aiken, R.; Batchelor, T.; Campbell, T.; Fulton, D.; Gilbert, M.; Heros, D.; Rogers, L.; O'Day, S. J.; Akerley, W.; Allen, J.; Baidas, S.; Gertler, S. Z.; Greenberg, H. S.; LaFollette, S.; Lesser, G.; Mason, W.; Recht, L.; Wong, E.; Chamberlain, M. C.; Cohn, A.; Glantz, M. J.; Gutheil, J. C.; Maria, B.; Moots, P.; New, P.; Russell, C.; Shapiro, W.; Swinnen, L.; Howell, S. B.

In: British Journal of Cancer, Vol. 84, No. 2, 13.02.2001, p. 157-163.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intrathecal treatment of neoplastic meningitis due to breast cancer with a slow-release formulation of cytarabine

AU - Jaeckle, Kurt

AU - Phuphanich, S.

AU - Van den Bent, M. J.

AU - Aiken, R.

AU - Batchelor, T.

AU - Campbell, T.

AU - Fulton, D.

AU - Gilbert, M.

AU - Heros, D.

AU - Rogers, L.

AU - O'Day, S. J.

AU - Akerley, W.

AU - Allen, J.

AU - Baidas, S.

AU - Gertler, S. Z.

AU - Greenberg, H. S.

AU - LaFollette, S.

AU - Lesser, G.

AU - Mason, W.

AU - Recht, L.

AU - Wong, E.

AU - Chamberlain, M. C.

AU - Cohn, A.

AU - Glantz, M. J.

AU - Gutheil, J. C.

AU - Maria, B.

AU - Moots, P.

AU - New, P.

AU - Russell, C.

AU - Shapiro, W.

AU - Swinnen, L.

AU - Howell, S. B.

PY - 2001/2/13

Y1 - 2001/2/13

N2 - Depocyte is a slow-release formulation of cytarabine designed for intrathecal administration. The goal of this multi-centre cohort study was to determine the safety and efficacy of DepoCyte for the intrathecal treatment of neoplastic meningitis due to breast cancer. DepoCyte 50 mg was injected once every 2 weeks for one month of induction therapy; responding patients were treated with an additional 3 months of consolidation therapy. All patients had metastatic breast cancer and a positive CSF cytology or neurologic findings characteristic of neoplastic meningitis. The median number of DepoCyte doses was 3, and 85% of patients completed the planned 1 month induction. Median follow up is currently 19 months. The primary endpoint was response, defined as conversion of the CSF cytology from positive to negative at all sites known to be positive, and the absence of neurologic progression at the time the cytologic conversion was documented. The response rate among the 43 evaluable patients was 28% (CI 95%: 14-41%); the intent-to-treat response rate was 21% (CI 95%: 12-34%). Median time to neurologic progression was 49 days (range 1-515 +); median survival was 88 days (range 1-515 +), and 1 year survival is projected to be 19%. The major adverse events were headache and arachnoiditis. When drug-related, these were largely of low grade, transient and reversible. Headache occurred on 11% of cycles; 90% were grade 1 or 2. Arachnoiditis occurred on 19% of cycles; 88% were grade 1 or 2. DepoCyte demonstrated activity in neoplastic meningitis due to breast cancer that is comparable to results reported with conventional intrathecal agents. However, this activity was achieved with one fourth as many intrathecal injections as typically required in conventional therapy. The every 2 week dose schedule is a major advantage for both patients and physicians.

AB - Depocyte is a slow-release formulation of cytarabine designed for intrathecal administration. The goal of this multi-centre cohort study was to determine the safety and efficacy of DepoCyte for the intrathecal treatment of neoplastic meningitis due to breast cancer. DepoCyte 50 mg was injected once every 2 weeks for one month of induction therapy; responding patients were treated with an additional 3 months of consolidation therapy. All patients had metastatic breast cancer and a positive CSF cytology or neurologic findings characteristic of neoplastic meningitis. The median number of DepoCyte doses was 3, and 85% of patients completed the planned 1 month induction. Median follow up is currently 19 months. The primary endpoint was response, defined as conversion of the CSF cytology from positive to negative at all sites known to be positive, and the absence of neurologic progression at the time the cytologic conversion was documented. The response rate among the 43 evaluable patients was 28% (CI 95%: 14-41%); the intent-to-treat response rate was 21% (CI 95%: 12-34%). Median time to neurologic progression was 49 days (range 1-515 +); median survival was 88 days (range 1-515 +), and 1 year survival is projected to be 19%. The major adverse events were headache and arachnoiditis. When drug-related, these were largely of low grade, transient and reversible. Headache occurred on 11% of cycles; 90% were grade 1 or 2. Arachnoiditis occurred on 19% of cycles; 88% were grade 1 or 2. DepoCyte demonstrated activity in neoplastic meningitis due to breast cancer that is comparable to results reported with conventional intrathecal agents. However, this activity was achieved with one fourth as many intrathecal injections as typically required in conventional therapy. The every 2 week dose schedule is a major advantage for both patients and physicians.

UR - http://www.scopus.com/inward/record.url?scp=17744379386&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=17744379386&partnerID=8YFLogxK

U2 - 10.1054/bjoc.2000.1574

DO - 10.1054/bjoc.2000.1574

M3 - Article

VL - 84

SP - 157

EP - 163

JO - British Journal of Cancer

JF - British Journal of Cancer

SN - 0007-0920

IS - 2

ER -