Real-life clinical benefit of oral metronomic cyclophosphamide administration in elderly and heavily pretreated epithelial ovarian cancer patients.

Autor: Attianese D; Academic Division of Gynecology and Obstetrics, University of Torino, Mauriziano Umberto I Hospital, Torino, Italy., Massobrio R; Academic Division of Gynecology and Obstetrics, University of Torino, Mauriziano Umberto I Hospital, Torino, Italy., Giorgi M; Academic Division of Gynecology and Obstetrics, University of Torino, Mauriziano Umberto I Hospital, Torino, Italy., Villa M; Division of Gynecology and Obstetrics, Cardinal Massaia Hospital, Asti, Italy., Fuso L; Academic Division of Gynecology and Obstetrics, University of Torino, Mauriziano Umberto I Hospital, Torino, Italy., Badellino E; Division of Gynecology and Obstetrics, Cardinal Massaia Hospital, Asti, Italy., Bellero M; Pharmacology Division of Mauriziano Umberto I Hospital, Torino, Italy., Ferrero A; Academic Division of Gynecology and Obstetrics, University of Torino, Mauriziano Umberto I Hospital, Torino, Italy. annamaria.ferrero@unito.it.; Department of Surgical Sciences, University of Torino, Torino, Italy. annamaria.ferrero@unito.it.
Jazyk: angličtina
Zdroj: Archives of gynecology and obstetrics [Arch Gynecol Obstet] 2024 Oct; Vol. 310 (4), pp. 2183-2190. Date of Electronic Publication: 2024 Aug 02.
DOI: 10.1007/s00404-024-07670-4
Abstrakt: Purpose: Oral metronomic cyclophosphamide (OMC) implicates the daily administration of low doses of chemotherapy. Its antitumor activity combined with an oral administration route and a good toxicity profile makes OMC an attractive option for heavily pretreated patients. We retrospectively evaluated OMC's clinical benefit and objective response in recurrent ovarian cancer patients.
Methods: This is a retrospective observational study involving patients treated with OMC (50 mg daily) from 2017 to 2022 at the Academic Division Gynaecology, Mauriziano Hospital, Torino, Italy. Clinical benefit assessment included CA125 response, radiological response, and reported symptomatic improvement. Toxicities were reported using Common Terminology Criteria for Adverse Events version 5.0.
Results: Thirty-eight patients (average age 72, range 49-88) were included. 90% had FIGO stage III/IV at diagnosis and 64% underwent ≥ 3 previous lines of chemotherapy. Before OMC, 79% had ECOG 1 or 2. 8.6% of patients had a partial response (PR), and 40% a stable disease (SD). Median duration of response was 7.4 months. After 3 months on OMC, 51% experienced symptom improvement, and 53.3% experienced Ca125 reduction or stabilization. 66.7% of patients older than 75 responded to treatment; in 40% of cases, responses lasted ≥ 6 months (p = 0.08). No G3-4 hematological toxicities occurred. Nausea and fatigue G1-G2 were reported in 5 (13%) and 13 (34%) cases, respectively.
Conclusion: OMC is a feasible therapeutic option for recurrent ovarian cancer, providing satisfying clinical responses with a good toxicity profile, even in elderly and heavily pretreated patients with a suboptimal performance status.
(© 2024. The Author(s).)
Databáze: MEDLINE
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