EVE/cyclosporin (etoposide, vincristine, epirubicin with high-dose cyclosporin)-chemotherapy selected for multidrug resistance modulation

Eur J Cancer. 2002 Dec;38(18):2422-7. doi: 10.1016/s0959-8049(02)00493-8.

Abstract

Sixteen children and young adults were treated with high-dose cyclosporin combined with a combination of cytotoxics (epirubicin, vincristine and etoposide) (EVE) known to be influenced by P-glycoprotein-mediated multidrug resistance (MDR). Tumour types were neuroblastoma 3, Ewing's sarcoma 2, rhabdomyosarcoma 5, osteosarcoma 3, desmoplastic small round cell tumour 1, nephroblastoma 1, T-acute lymphoblastic leukaemia (ALL) 1. All had progressed or relapsed following at least two of the drug types included in EVE. Acute reactions to cyclosporin and myelosuppression were the major toxicities documented. Renal and hepatic toxicity was rarely severe and always transient. Partial responses (PR) were observed in 2 patients (1 rhabdomyosarcoma, 1 Ewing's sarcoma). We conclude that this combination is tolerable in heavily pretreated patients and may be suitable for further evaluation in untreated poor risk tumours.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Child
  • Child, Preschool
  • Cyclosporine / administration & dosage
  • Cyclosporine / adverse effects
  • Drug Resistance, Multiple
  • Drug Resistance, Neoplasm
  • Epirubicin / administration & dosage
  • Epirubicin / adverse effects
  • Etoposide / administration & dosage
  • Etoposide / adverse effects
  • Female
  • Gastrointestinal Diseases / chemically induced
  • Heart Diseases / chemically induced
  • Hematologic Diseases / chemically induced
  • Humans
  • Kidney Diseases / chemically induced
  • Male
  • Neoplasms / drug therapy*
  • Vincristine / administration & dosage
  • Vincristine / adverse effects

Substances

  • Epirubicin
  • Vincristine
  • Etoposide
  • Cyclosporine