Oral cyclophosphamide in recurrent ovarian cancer

Handolias, Despina; Quinn, Michael; Foo, Serene S; Mileshkin, Linda; Grant, Peter; Dutu, Gaelle; Rischin, Danny

doi:10.1111/ajco.12074

Cited by 28 publications

(22 citation statements)

References 33 publications

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“…[913] In our study oral etoposide therapy was less tolerated with overall response rate of 16.6% (partial response) which was similar to other similar to other studies. [1011] In our study, no complete response was noted in the oral etoposide group.…”

Section: Discussionsupporting

confidence: 89%

Continuous low-dose oral chemotherapy in recurrent and persistent carcinoma of cervix following chemoradiation: A comparative study between prolonged oral cyclophosphamide and oral etoposide

Baruah¹,

Barmon²,

Hazarika³

et al. 2014

Indian J Palliat Care

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Aim:To compare the efficacy and toxicities of low-dose oral cyclophosphamide and oral etoposide in patients with persistent and recurrent cervical cancer with gross pelvic disease following full course of chemoradiation therapy.Materials and Methods:30 patients with recurrent and persistent cervical cancer with gross pelvic disease were enrolled in this trial. The patients were randomly divided into two groups of 15 patients each with one group receiving low dose oral cyclophosphamide (100 mg/day) and the other group receiving low-dose oral etoposide (50 mg/day). Results were statistically analysed by IBM SPSS Statistics 19.Results:Oral etoposide was not well tolerated with grade 2 neutropenia occurring in 33.3% and grade 3 neutropenia in 6.6% and thrombocytopenia occurring in 13.3%. Oral cyclophosphamide group on the other hand was better tolerated with none of the patients having thrombocytopenia and 6.6% patients having grade 2 neutropenia. There were two complete response (15.38%) and one partial response at the end of study (7.6%) in the cyclophosphamide group whereas there was no complete response and two partial response (16.6%) in the oral etoposide group.Conclusion:Long-term, low-dose oral etoposide was found to be less tolerated without any significant effect with patients with persistent and recurrent cervical cancer with gross pelvic disease following full course of chemoradiation therapy in contrast to oral cyclophosphamide which was found to be effective and well-tolerated by the patients.

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Section: Discussionsupporting

confidence: 89%

Continuous low-dose oral chemotherapy in recurrent and persistent carcinoma of cervix following chemoradiation: A comparative study between prolonged oral cyclophosphamide and oral etoposide

Baruah¹,

Barmon²,

Hazarika³

et al. 2014

Indian J Palliat Care

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“…This profile of toxicity thus appears more favorable compared to previously reported experiences with MOC which, nonetheless, utilized slightly higher doses of the drug, i.e. 50–150 mg daily [ 13 ], or 50 mg twice a day for 3 weeks with a 1-week break [ 15 ], or 50–150 mg d1-14, every 4 weeks [ 16 ]. This observation, together with the recognized anti-angiogenic activity of MOC have provided the rationale for its combination with bevacizumab in retrospective as well as prospective studies which showed values of median PFS (range = 3.0-7.2 months) [ 29 – 31 ] comparable to our and previous results [ 16 ].…”

Section: Discussionmentioning

confidence: 88%

“…This consideration, together with the use of response evaluation criteria completely different from the current standard, intuitively precluded any reliable comparison with our results. A more recent feasibility study including 14 ROC patients documented an ORR to MOC of 7.1%, while a retrospective review of a similar patient setting reported a 44% response rate [ 16 ]; nonetheless, the reliability of these data are heavily impaired by the very small sample series [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the scenario of palliative treatments for heavily treated, recurrent ovarian cancer (ROC) patients, much attention has been focused on metronomic oral cyclophosphamide (MOC): in particular, very early experiences had suggested its possible activity in advanced ovarian cancer patients failing treatment or not amenable to surgery or radiotherapy [ 13 ]. More recently, anedoctal cases and small sample series have highlighted the promising rates of response to MOC in ROC patients [ 14 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Metronomic oral cyclophosphamide (MOC) in the salvage therapy of heavily treated recurrent ovarian cancer patients: a retrospective, multicenter study

et al. 2014

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BackgroundThe aim of this multicenter, retrospective study was to evaluate the efficacy and safety of metronomic oral cyclophosphamide (MOC) in heavily treated, relapsed ovarian cancer (ROC) patients.Methodsoral cyclophosphamide (Endoxan®, Baxter, Italy) was administered at the dose of 50 mg daily, continuously. Treatment-related toxicity and response to treatment were assessed by the NCI-CTC criteria, and RECIST criteria, respectively. Progression-free (PFS), and overall survival (OS) were also assessed.Results54 patients were analyzed: 20 patients (37.0%) were considered primarily platinum refractory/resistant, while 34 patients (63.0%) were defined as platinum sensitive; 79.6% of patients had received ≥2 previous lines before starting MOC. The objective response rate (ORR) was 20.4%. Eleven patients (20.4%) experienced stable disease and 8 of them had a response duration ≥6 months. A total of 32 patients (59.2.%) progressed during treatment. Median PFS was 4 months, and the 12-month PFS rate was 19.6%; median OS was 13 months, and the 12-month OS rate was 51.5% . Patients responding to MOC showed a more favorable PFS (median = 17 months) compared to patients with stabilization (median = 6 months) or progression of disease (median = 3 months) (p value = 0.0001). Median OS of responding patients was 30 months compared to 11 months in cases achieving stabilization, or progression of disease (median = 8 months) (p value = 0.0001). Only 1 patient experienced grade 3 anemia. Non-hematological grade 3 toxicity was registered in 2 patients.ConclusionsMOC could provide a valid alternative in terms of risk/benefit ratio in the palliative treatment of heavily treated ROC patients.

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“…We know that OMC has anti-tumor activity by itself in ovarian cancer [7]. The main primary target of OMC is thought to be the tumor's neovasculature.…”

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confidence: 99%

Bevacizumab and oral metronomic cyclophosphamide in platinum-resistant ovarian cancer

Pujade-Lauraine

2013

J Gynecol Oncol

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Oral cyclophosphamide in recurrent ovarian cancer

Abstract: Single agent oral cyclophosphamide is active and well tolerated in recurrent ovarian cancer. Further investigation of oral cyclophosphamide in patients with platinum-sensitive and platinum-resistant disease is warranted.

Cited by 28 publications

References 33 publications

Continuous low-dose oral chemotherapy in recurrent and persistent carcinoma of cervix following chemoradiation: A comparative study between prolonged oral cyclophosphamide and oral etoposide

Continuous low-dose oral chemotherapy in recurrent and persistent carcinoma of cervix following chemoradiation: A comparative study between prolonged oral cyclophosphamide and oral etoposide

Metronomic oral cyclophosphamide (MOC) in the salvage therapy of heavily treated recurrent ovarian cancer patients: a retrospective, multicenter study

Bevacizumab and oral metronomic cyclophosphamide in platinum-resistant ovarian cancer

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