Intra-Arterial (IA) Chemotherapy for Newly Diagnosed, Residual, or Recurrent Atypical Choroid Plexus Papilloma (ACPP) and Choroid Plexus Carcinoma (CPC) Prior to Second-Look Surgery
This study will test the safety and efficacy of intra-arterial chemotherapy in subjects with newly diagnosed, residual, or recurrent atypical choroid plexus papilloma and choroid plexus carcinoma prior to a second surgery. It is believed that intra-arterial chemotherapy will be safe and feasible for this population and will result in decreased tumor size, which may further improve the goals of a second-look surgery.
• Subjects with a histologically confirmed diagnosis of ACPP or CPC that is newly diagnosed, residual or recurrent.
• Subjects must have a Karnofsky or Lansky Performance Score ≥ 60 % assessed within two weeks prior to enrollment. Karnofsky is used for patients ≥ 16 years and Lansky for those \< 16.
• Subjects must have normal organ and marrow function documented within 14 days of enrollment and within 7 days of the start of treatment as noted below:
∙ Absolute neutrophil count ≥ 1,000/μL
‣ Platelets ≥ 100,000/μL (transfusion independent, defined as not receiving platelet transfusions within a 7-day period prior to enrollment)
‣ Hemoglobin ≥ 8 g/dL (may receive PRBC transfusions)
‣ Total bilirubin \< 1.5 times upper limit of normal for age
‣ AST (SGOT)/ALT(SGPT) \< 2.5 X institutional upper limit of normal for age
‣ Creatinine clearance or radioisotope GFR ≥ 70 ml/min/1.73m2 or a serum creatinine WNL for age as determined using the Schwartz formula.36
‣ Sodium, Potassium, Calcium and Magnesium \< 1.5x institutional ULN
‣ Albumin ≥ 3 g/dL
• Subjects who are receiving dexamethasone must be on a stable or decreasing dose for at least 1 week prior to enrollment.
• Subjects with neurological deficits should have deficits that are stable for a minimum of 1 week prior to enrollment.
• If the subject has any of the following therapies, must be at least:
‣ 4 weeks post-focal RT (radiation therapy), 3 months post-CSI (craniospinal irradiation)
⁃ 4 weeks post-myelosuppressive chemotherapy (if post-nitrosoureas, must have 6 weeks therapy)
⁃ 4 weeks post-monoclonal antibodies
⁃ 1 week post-targeted therapy
• If subject has received any previous treatment, all treatment related toxicities should have recovered to \< grade 2
• Subject or parent must sign a written informed consent document according to institutional guidelines.