Inhaled lipid cisplatin (ILC) in the treatment of patients with relapsed/progressive osteosarcoma metastatic to the lung

Alexander Ja-Ho Chou, Renu Gupta, Moshe D. Bell, Kathleen O Day Riewe, Paul A. Meyers, Richard Gorlick

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: Osteosarcoma treatment failure is most often from the inability to control metastatic disease in the lungs. Encapsulating cisplatin within lipid complexes and delivering the agent via inhalation targets lung metastases with minimal systemic exposure. An open-label, phase Ib/IIa study was performed to characterize the safety and efficacy of inhaled lipid cisplatin (ILC) in recurrent osteosarcoma patients who only had pulmonary metastases. Procedure: ILC was administered via nebulizer every 2 weeks (=1 cycle). Response was evaluated radiographically every 2 cycles. Cisplatin levels were measured in patients. When possible, metastasectomy was undertaken in patients after 2 cycles. Results: Nineteen patients were treated. No patients experienced hematologic toxicity, nephrotoxicity or ototoxicity. Nausea/vomiting (≥grade 3) was attributed to study drug in one patient. Respiratory symptoms were observed in 13/19 patients with only one patient experiencing a ≥grade 3 respiratory symptom (not related to study drug). Systemic cisplatin exposure was minimal. Eleven patients had bulky disease, and all progressed prior to cycle 7. Eight patients had all lesions ≤2cm. One patient had a sustained partial response. An additional two patients had stable disease after 2 cycles, underwent metastasectomy, and remained free from pulmonary recurrence 1 year after initiation of therapy. Conclusions: ILC is well tolerated in heavily treated osteosarcoma patients and did not appear to have the typical toxicities associated with intravenous cisplatin. Three of eight patients with less bulky disease had sustained benefit. Further study of ILC is warranted.

Original languageEnglish (US)
Pages (from-to)580-586
Number of pages7
JournalPediatric Blood and Cancer
Volume60
Issue number4
DOIs
StatePublished - Apr 2013

Fingerprint

Osteosarcoma
Cisplatin
Lipids
Lung
Therapeutics
Metastasectomy
Neoplasm Metastasis
Nebulizers and Vaporizers
Treatment Failure
Pharmaceutical Preparations
Nausea
Inhalation
Lung Diseases
Vomiting

Keywords

  • Clinical trials, inhaled cisplatin
  • New agents
  • Recurrent osteosarcoma

ASJC Scopus subject areas

  • Oncology
  • Pediatrics, Perinatology, and Child Health
  • Hematology

Cite this

Inhaled lipid cisplatin (ILC) in the treatment of patients with relapsed/progressive osteosarcoma metastatic to the lung. / Chou, Alexander Ja-Ho; Gupta, Renu; Bell, Moshe D.; Riewe, Kathleen O Day; Meyers, Paul A.; Gorlick, Richard.

In: Pediatric Blood and Cancer, Vol. 60, No. 4, 04.2013, p. 580-586.

Research output: Contribution to journalArticle

Chou, Alexander Ja-Ho ; Gupta, Renu ; Bell, Moshe D. ; Riewe, Kathleen O Day ; Meyers, Paul A. ; Gorlick, Richard. / Inhaled lipid cisplatin (ILC) in the treatment of patients with relapsed/progressive osteosarcoma metastatic to the lung. In: Pediatric Blood and Cancer. 2013 ; Vol. 60, No. 4. pp. 580-586.
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