Metronomic Oral Cyclophosphamide Chemotherapy Possibly Contributes to Stabilization of Disease in Patients With Metastatic Castration-Resistant Prostate Cancer: A Prospective Analysis of Consecutive Cases

Yashi, Masahiro; Nishihara, Daisaku; Mizuno, Tomoya; Yano, Hideo; Masuda, Akinori; Kambara, Tsunehito; Betsunoh, Hironori; Abe, Hideyuki; Fukabori, Yoshitatsu; Muraishi, Osamu; Kamai, Takao

doi:10.1016/j.clgc.2014.02.007

Cited by 14 publications

(16 citation statements)

References 29 publications

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“…Dose interruptions or modifications were not required for cyclophosphamide. This favorable toxicity profile is in accord with the previously reported well‐known tolerability of metronomic therapy, even in elderly, heavily treated and unfit patients . However, edema and infections were problematic, as six patients required dexamethasone dose reduction because of peripheral edema, and at least temporary dose interruption was required in three patients because of infections, such as cellulitis or upper respiratory infections.…”

Section: Discussionsupporting

confidence: 86%

“…The PSA response rate was 39% with a median TTPSA of 5.2 months, and no patients required dose reduction or dose delay of cyclophosphamide. Although indirect comparison of different studies is not recommended, our results are comparable with those studies that administered metronomic chemotherapy with oral cyclophosphamide …”

Section: Discussionsupporting

confidence: 82%

“…Recent studies showed that metronomic chemotherapy with oral cyclophosphamide plus a variety of agents (e.g. prednisone, celecoxib, dexamethasone, methotrexate, uracil with tegafur or capecitabine) showed significant effectiveness, as assessed by the kinetics of prostate‐specific antigen (PSA) levels and pain control without significant toxicity, even in heavily pretreated patients . Thus, low‐dose metronomic cyclophosphamide may have the potential to be used as an alternative therapeutic option in mCRPC, especially in situation when accessibility to newer agents is limited.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of metronomic oral cyclophosphamide with low dose dexamethasone and celecoxib in metastatic castration-resistant prostate cancer

Jeong

Lee

2016

Asia-Pac J Clin Oncol

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Prostate cancer is the most common cancer among men with 27% of all male cancer cases. JEONG et al. evaluated the clinical efficacy and tolerance of metronomic oral cyclophosphamide with celecoxib and dexam-ethasone in Korean patients with metastatic castration-resistant prostate cancer (mCRPC) and found that the prostate-specific antigen (PSA) response rate was 39%. The median time to PSA progression (TTPSA) was 5.2 months. The median time to composite progression was 3.9 months and a median overall survival was 13.3 months. Clinically significant adverse events only occurred in six patients. It is concluded that metro-nomic oral cyclophosphamide could be used as a viable option with advantages of promising response rate and high tolerability in patients with mCRPC (pp. 204-211). ORIGINAL ARTICLE 125 Iodine brachytherapy via a trans-superior vena cava approach in patients with metastases in middle mediastinal lymph nodes: A novel approach Mediastinal lymph node metastases can be life threatening owing to their proximity to vital organs. Liu et al. aimed to explore a novel trans-superior vena cava approach for such nodes in 32 patients with 43 pathologically confirmed metastasiscontaining mediastinal middle lymph nodes underwent CT-guided percuta-neous 125 I brachytherapy via a trans-superior vena cava approach and found that complete responses were achieved in 22 patients (68.75%) and partial response in four (12.5%); the overall response rate was 81.25%. The 1-and 3-year overall survival rates were 53.13% and 28.13%, respectively. The authors concluded that CT-guided 125 I brachytherapy via a trans-SVC approach is safe, and had no serious complications for patients with middle mediastinal lymph node metastases (pp. 219-225). ORIGINAL ARTICLE Concurrent chemoradiation with cisplatin and vinorelbine followed by consolidation with oral vinorelbine in locally advanced non-small cell lung cancer (NSCLC): the phase II CONCAVE study Lung cancer is biologically aggressive and is the leading cause of cancer-related deaths. The study evaluated the effect of combination of ciplatin/vinorelbine and concurrent thoracic radiotherapy followed by consolidation oral vinorelbine for patients with stage III non-small cell lung cancer (NSCLC) and found that overall response rate (ORR) was 81% and disease control rate of 93%. The median PFS was 11 months and median OS was 26 months. Concurrent chemoradiotherapy (CRT) was reasonably well tolerated with manageable toxicities. Consolidation chemotherapy was more toxic however. The estimated 5-year OS was 34.6%. The results of this study suggested that consolidation oral vinorelbine after CRT demonstrated an encouraging ORR, favorable median and 5-year survival time, but displayed unacceptable toxicity (pp. 137-144). ORIGINAL ARTICLE Treatment patterns in patients with advanced gastric cancer in Taiwan Gastric cancer is the fifth most frequent cancer and the second cause of cancer-related mortalities worldwide. The objective of this study was to describe real-world treatment patterns ...

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

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Efficacy of metronomic oral cyclophosphamide with low dose dexamethasone and celecoxib in metastatic castration-resistant prostate cancer

Jeong

Lee

2016

Asia-Pac J Clin Oncol

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“…A retrospective analysis of CP plus prednisolone regimen reported a more than 50% PSA decrease in 26%of patients [101]. Additionally, in a study of 24 patients, the median PSA progression-free survival was 5.0 months and a PSA decrease of 50% was observed in 8 patients (33.3%) [102]. In a multicenter retrospective study with 48 patients pretreated with docetaxel and another drug, efficacy of metronomic CPA was retrospectively evaluated.…”

Section: Resultsmentioning

confidence: 99%

Metronomic Chemotherapy: A Systematic Review of the Literature and Clinical Experience

Şimşek

Esin

Yalçın

2019

Journal of Oncology

102

100

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Metronomic chemotherapy, continuous and dose-dense administration of chemotherapeutic drugs with lowered doses, is being evaluated for substituting, augmenting, or appending conventional maximum tolerated dose regimens, with preclinical and clinical studies for the past few decades. To date, the principle mechanisms of its action include impeding tumoral angiogenesis and modulation of hosts’ immune system, affecting directly tumor cells, their progenitors, and neighboring stromal cells. Its better toxicity profile, lower cost, and easier use are main advantages over conventional therapies. The evidence of metronomic chemotherapy for personalized medicine is growing, starting with unfit elderly patients and also for palliative treatment. The literature reviewed in this article mainly demonstrates that metronomic chemotherapy is advantageous for selected patients and for certain types of malignancies, which make it a promising therapeutic approach for filling in the gaps. More clinical studies are needed to establish a solidified role for metronomic chemotherapy with other treatment models in modern cancer management.

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“…The combination of carboplatin-etoposide appears to be superior to other regimens, such as trabectedin (median PFS 1.5 months; 95% CI: 0.9–1.8) ( 16 ). With metronomic oral cyclophosphamide, the median PFS was 5 months (95% CI: 3–8) and the median OS 19 months (95% CI: 8–28) ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Carboplatin-etoposide combination chemotherapy in metastatic castration-resistant prostate cancer: A retrospective study

Caubet

Dobi

Pozet

et al. 2015

Molecular and Clinical Oncology

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The combination of cisplatin or carboplatin and etoposide is the standard treatment for certain poorly differentiated neuroendocrine cancers, such as small-cell lung cancer. The aim of this study was to assess the efficacy and tolerability of the carboplatin-etoposide regimen in metastatic castration-resistant prostate cancer (mCRPC). A total of 27 patients treated by carboplatin [area under the curve (AUC)=5] and etoposide (100 mg/m2 intravenous infusion on days 1–3 or 75 mg orally/day for 10 days) for mCRPC were included for analysis. The median progression-free survival was 3.3 months [95% confidence interval (CI): 1.9–4.2] and the median overall survival (OS) was 8.1 months (95% CI: 4.06–12.36). The main grade 3–4 toxicities were haematological, namely anemia (33.3%), neutropenia (25.9%) and thrombocytopenia (22.2%), whereas the most common non-hematological toxicity was asthenia (22.2%). The efficacy, compliance and safety profile were generally similar between the oral and intravenous etoposide groups. Pretreated patients with mCRPC may benefit from the carboplatin-etoposide regimen in terms of OS. The toxicities were acceptable, without reported treatment-related mortality. Therefore, the oral etoposide regimen may be an viable alternative for improving the quality of life of the patients. However, this regimen requires further prospective investigation to confirm its efficacy.

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Metronomic Oral Cyclophosphamide Chemotherapy Possibly Contributes to Stabilization of Disease in Patients With Metastatic Castration-Resistant Prostate Cancer: A Prospective Analysis of Consecutive Cases

Cited by 14 publications

References 29 publications

Efficacy of metronomic oral cyclophosphamide with low dose dexamethasone and celecoxib in metastatic castration-resistant prostate cancer

Efficacy of metronomic oral cyclophosphamide with low dose dexamethasone and celecoxib in metastatic castration-resistant prostate cancer

Metronomic Chemotherapy: A Systematic Review of the Literature and Clinical Experience

Carboplatin-etoposide combination chemotherapy in metastatic castration-resistant prostate cancer: A retrospective study

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