Theoretical considerations based on pharmacokinetic data, studies of cisplatin and topotecan done in adults, and recent in vitro data, suggests that the combination would be synergistic, and efficacious against pediatric cancer where individual drugs are not. The present study plan uses a standard phase I design. The study remains open in active accrual. Children's Hospital of Pittsburgh has entered three patients, two successfully completed the administration of topotecan and cisplatin as per the protocol. Toxicity was not excessive. One of three patients remains alive with stable disease. Patients with significant bone marrow disease or a lack of bone marrow reserve, are excluded from this study.
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