Retinoblastoma management in 13q deletion syndrome patients using super-selective chemotherapies and other cancer-directed interventions

Lucy V. Cobbs, Jasmine H. Francis, Ira J. Dunkel, Y. Pierre Gobin, Scott E. Brodie, David H. Abramson

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: This study aimed to identify best practices for treating 13q deletion syndrome (13q−) patients with retinoblastoma in the era of super-selective ophthalmic artery chemosurgery (OAC) and intravitreal injection therapy (IVIT). Methods: Retrospective study of 21 eyes from 14 patients with retinoblastoma and 13q− who were treated at Memorial Sloan Kettering Cancer Center (MSKCC) between May 2006 and May 2020, with a mean follow up of 3.7 years. Ocular survival, patient survival, and treatment toxicities were assessed. Results: Nine of the 12 eyes that underwent OAC/IVIT at MSKCC have been progression free for at least 1 year since their last treatments. Fifteen out of 26 OAC cycles resulted in grade 3-4 hematologic toxicity. There was one death from sepsis in the setting of intravenous chemotherapy (IVC) for metastatic disease that occurred after OAC/IVIT therapy. The 2-year Kaplan-Meier ocular survival estimate for the whole cohort was 75% and for the eyes that received OAC or IVIT at MSKCC 83%. For OAC hematologic toxicities, one platelet transfusion and two filgrastim doses were administered, and one patient was hospitalized for neutropenic fevers. Conclusions: The majority of 13q− eyes treated with OAC/IVIT-based regimens can be cured, and there were no deaths related to complications from OAC or IVIT. 13q− Patients did have increased risk of systemic treatment complications, even from super-selective chemotherapies. Despite these toxicities, only one patient developed febrile neutropenia, one patient required a blood product transfusion, and two patients received filgrastim for both OAC and IVC complications. Précis: Children with 13q deletion syndrome with retinoblastoma managed with intra-arterial and intravitreal chemotherapy have excellent patient and ocular survival with acceptable toxicity.

Original languageEnglish
Article numbere28845
JournalPediatric Blood and Cancer
Volume68
Issue number5
DOIs
StatePublished - May 2021
Externally publishedYes

Keywords

  • chemotherapy toxicities
  • clinical genetics
  • retinoblastoma

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