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Oral etoposide as a single agent in childhood and young adult cancer in England: Still a poorly evaluated palliative treatment

Fraser, J; Fardus-Reid, F; Irvine, L; Elliss-Brookes, L; Fern, L; Cameron, AL; Pritchard-Jones, K; ... McCabe, MG; + view all (2021) Oral etoposide as a single agent in childhood and young adult cancer in England: Still a poorly evaluated palliative treatment. Pediatric Blood & Cancer , Article e29204. 10.1002/pbc.29204. (In press). Green open access

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Abstract

BACKGROUND: Oral etoposide is commonly used in palliative treatment of childhood and young adult cancer without robust evidence. We describe a national, unselected cohort of young people in England treated with oral etoposide using routinely collected, population-level data. METHODS: Patients aged under 25 years at cancer diagnosis (1995-2017) with a treatment record of single-agent oral etoposide in the Systemic AntiCancer Dataset (SACT, 2012-2018) were identified, linked to national cancer registry data using NHS number and followed to 5 January 2019. Overall survival (OS) was estimated for all tumours combined and by tumour group. A Cox model was applied accounting for age, sex, tumour type, prior and subsequent chemotherapy. RESULTS: Total 115 patients were identified during the study period. Mean age was 11.8 years at cancer diagnosis and 15.5 years at treatment with oral etoposide. Median OS was 5.5 months from the start of etoposide; 13 patients survived beyond 2 years. Survival was shortest in patients with osteosarcoma (median survival 3.6 months) and longest in CNS embryonal tumours (15.5 months). Across the cohort, a median of one cycle (range one to nine) of etoposide was delivered. OS correlated significantly with tumour type and prior chemotherapy, but not with other variables. CONCLUSIONS: This report is the largest series to date of oral etoposide use in childhood and young adult cancer. Most patients treated in this real world setting died quickly. Despite decades of use, there are still no robust data demonstrating a clear benefit of oral etoposide for survival.

Type: Article
Title: Oral etoposide as a single agent in childhood and young adult cancer in England: Still a poorly evaluated palliative treatment
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/pbc.29204
Publisher version: https://doi.org/10.1002/pbc.29204
Language: English
Additional information: Copyright © 2021 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Keywords: AYA, cancer, children, etoposide, population, survival
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept
URI: https://discovery.ucl.ac.uk/id/eprint/10131559
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