Bevacizumab and oral metronomic cyclophosphamide in platinum-resistant ovarian cancer

Pujade-Lauraine, Éric

doi:10.3802/jgo.2013.24.3.209

Cited by 7 publications

(8 citation statements)

References 11 publications

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“…Some single and series case reports described the benefit of adding bevacizumab to MCT with Cy [ 34 – 36 ]; and one retrospective review describe that the addition of Cy to intravenous bevacizumab in heavily pre-treated patients with recurrent ovarian carcinoma improved PFS and OS in responders. However, the adverse events are not well described [ 37 , 38 ]. Also, the cost-effective ratio of bevacizumab in OC is not totally clear [ 39 ], as well as the combination of bevacizumab with metronomic Cy.…”

Section: Discussionmentioning

confidence: 99%

Clinical response in patients with ovarian cancer treated with

Perroud

Scharovsky

Rozados

et al. 2017

ecancer

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Ovarian cancer (OC) is the leading cause of death from gynaecological cancer. It is extremely hard to diagnose in the early stages and around 70% of patients present with advanced disease. Metronomic chemotherapy (MCT) is described as the chronic administration of, generally low, equally spaced, doses of chemotherapeutic drugs with therapeutic efficacy and low toxicity. This is an effective and low-cost way to treat several types of tumours, including ovarian cancer. Here, we present six cases of advanced ovarian cancer treated with MCT with low doses of cyclophosphamide, which showed clinical response and stable disease.

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Section: Discussionmentioning

confidence: 99%

Clinical response in patients with ovarian cancer treated with

Perroud

Scharovsky

Rozados

et al. 2017

ecancer

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“…On the other side, in metronomics, the chemotherapeutic drugs are given in low doses or, at least, in doses lower than the maximum tolerated dose and repurposed drugs, as Cel, are administered with a metronomic schedule in the standard, nontoxic doses. In fact, it has already been demonstrated that metronomic chemotherapy is effective in different types of tumors and it is endowed of a low toxicity profile [26][27][28][29][30][31][32][33][34][35] b ringing about no deterioration of patients' QoL.…”

Section: Discussionmentioning

confidence: 99%

Quality of Life in Patients with Metastatic Breast Cancer Treated with Metronomic Chemotherapy

et al. 2016

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Aim:The objective of the study was to detect changes in quality of life (QoL) in metastatic breast cancer patients treated with metronomic chemotherapy with daily low doses of cyclophosphamide and celecoxib. Material & methods: Patients included in a Phase II trial, treated with metronomic cyclophosphamide and celecoxib were included in the QoL study. Assessment of QoL was carried out every 2 months by the Functional Assessment of Cancer Therapy Breast (FACT-B) questionnaire, Brief Pain Inventory and Eastern Cooperative Oncologic Group scale. Data were analyzed at three time points: baseline (BL); middle of treatment (MT); and end of treatment (ET). Results: A total of 20 patients were included. All patients were heavily pretreated. Treatment showed a good and safe therapeutic profile. With FACT-B questionnaire, no significant differences were observed during the response period (BL-MT). However, a significant increase was observed in the Emotional wellbeing and Additional concerns axes, when the last time point was included in the analysis (BL-MT-ET). A significant decrease in the proportion of patients with pain was found when comparing BL with ET (p = 0.046). The assessment with Eastern Cooperative Oncologic Group scale showed that 26.7% (4/15) of the patients improved their functional status and 40% (6/15) showed no changes, while 33.3% (5/10) worsened it. Conclusion: Patients treated metronomically for several months did not worsen their QoL. A high proportion of patients showed improvement or no changes and there were less patients with pain at the end of the treatment. The quality of life (QoL) is a very common term used in different fields of human health. Therefore, it is very difficult to find a unique definition since it could be related to all aspects of human life [1].In an attempt to define it, it can be said that it is "the perfect balance between well-being and distress" [2,3]. The concept of adaptation to chronic disease is different but it is related to that of QoL; adaptation is the process whereby individuals use conscious awareness and choice to create new human environmental integration [4,5]. Both are good indicators of the evolution of psychological features of cancer patients at different stages of the disease [6]. In oncology QoL is centered in patients' health, and refers to all aspects (general, social, personal, emotional, among others) of 1234RESEaRch aRticlE Perroud, Alasino, Rico et al. future science group the subject and their relationship to the cancer disease and its treatment.The presence of pain is a very complex aspect related to QoL, and it is one of the most difficult symptoms to evaluate and to treat; in many cases pain is caused by the pressure that the tumor exerts on bones and/or nerves, and also it could be caused by cancer treatment. One of the barriers in pain treatment is the inadequate measurement and assessment of pain. An optimal management includes the evaluation of intensity, characteristics and interference with daily habits and life style [7,8].The meas...

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“…[ 9 10 11 ] Among studies in ovarian carcinoma, majority of studies using metronomic therapy have used in either relapsed/refractory ovarian carcinoma or in combination with standard chemotherapy to improve outcomes due to antiangiogenic effect with minimal toxicity. [ 11 12 13 14 ] As the cost of metronomic therapy is <16$/month compared to a single cycle of standard paclitaxel carbopaltin doublet (300$) with demonstrated benefit, we started the use of metronomic oral chemotherapy first in relapsed/refractory ovarian carcinoma followed by maintenance therapy after definitive treatment and finally as neoadjuvant therapy in nonaffording patients with poor tolerance to standard platin doublet.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of advanced epithelial ovarian cancer with integration of metronomic chemotherapy: An Indian rural cancer centre experience

Pandey

Abhay²,

Jandyal

et al. 2016

South Asian J Cancer

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Background:Paclitaxel-platinum and optimal cytoreductive surgery are the standard of care for ovarian carcinoma. Poor socioeconomic profile and therapeutic constraints in rural India poses a therapeutic challenge.Aim:To evaluate outcomes of epithelial ovarian carcinoma.Objectives:To calculate disease-free survival (DFS), overall survival (OS), and factors affecting outcomes.Materials and Methods:Data of patients diagnosed as ovarian carcinoma registered between March 2009 and March 2014 were retrieved. Demographic profile, chemotherapy and response, surgery, and disease progression were collected. Patients who underwent surgery or completed three cycles of chemotherapy were selected. Kaplan–Meir survival was used to determine disease-free and OS. Log-rank test used to evaluate factors affecting outcome.Results:Median follow-up is 26 months. 93/102 patients (91%) underwent cytoreductive surgery, of which 37 had primary cytoreduction (40%) while 56 had interval cytoreduction. 21/93 (23%), 57/93 (61%), and 15/93 (16%) patients were operated by local surgeons, surgeons of our hospital, and trained oncosurgeons, respectively. Induction paclitaxel-platinum was used in 35/63 (56%) patients while 28/63 patients (44%) received neoadjuvant metronomic chemotherapy. Median DFS and OS are 17 and 54 months respectively while 3 year OS of 66%. Median DFS of patients operated by oncosurgeons versus local surgeons were 22 months versus 15 months (P = 0.01), OS was 54 versus 26 months (P = 0.01).40/88 (45%) patients received maintenance metronomic therapy after adjuvant chemotherapy with median of 6 months (range 2–18 months). Patients receiving metronomic maintenance had better DFS, 18 months versus 15 months (P = 0.69).Conclusion:Induction therapy in ovarian carcinoma helps in selecting patients for cytoreductive surgery. Outcomes are better if operated by trained oncosurgeons. Maintenance metronomic has potential to delay disease progression.

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Bevacizumab and oral metronomic cyclophosphamide in platinum-resistant ovarian cancer

Cited by 7 publications

References 11 publications

Clinical response in patients with ovarian cancer treated with

Clinical response in patients with ovarian cancer treated with

Quality of Life in Patients with Metastatic Breast Cancer Treated with Metronomic Chemotherapy

Outcomes of advanced epithelial ovarian cancer with integration of metronomic chemotherapy: An Indian rural cancer centre experience

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