Antiangiogenetic therapy with pioglitazone, rofecoxib, and metronomic trofosfamide in patients with advanced malignant vascular tumors
| Autor: | Anna Berand, Albrecht Reichle, Christian Hafner, Klaus Bross, Reinhard Andreesen, Thomas Vogt, Michael Landthaler, Frauke Bataille, Karl-Walter Jauch |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty medicine.medical_treatment Hemangiosarcoma Administration Oral Angiogenesis Inhibitors Disease-Free Survival Hemangioendothelioma Lactones chemistry.chemical_compound Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Sulfones Cyclophosphamide Rofecoxib Aged Chemotherapy Pioglitazone Vascular disease business.industry Middle Aged medicine.disease Nitrogen mustard Trofosfamide Surgery Treatment Outcome chemistry Disease Progression Female Thiazolidinediones Sarcoma business medicine.drug |
| Zdroj: | Cancer. 98:2251-2256 |
| ISSN: | 1097-0142 0008-543X |
| DOI: | 10.1002/cncr.11775 |
| Popis: | BACKGROUND: Systemic therapy options for patients with advanced angiosarcomas are limited, and their prognosis is poor. The idea of angiostatic therapy following the paradigm of metronomic dosed chemotherapeutics combined with proapoptotic biomodulators had not been considered previously in these patients. Therefore, in a pilot study, the efficacy of metronomically scheduled, low-dose trofosfamide in combination with the peroxisome proliferator-activated receptor gamma agonist, pioglitazone, and the selective cyclooxygenase-2 inhibitor, rofecoxib, was evaluated in patients with advanced vascular malignancies. METHODS: Six patients with advanced and pretreated but progressive, malignant vascular tumors (5 angiosarcomas and 1 hemangioendothelioma) received a combination of pioglitazone (45 mg per day orally) plus rofecoxib (25 mg per day orally) and, after 14 days, trofosfamide (3 x 50 mg per day orally). The therapy was administered continuously until progression was observed. If necessary, doses were modified according to side effects. RESULTS: Two patients responded with complete remission of disease, one patient responded with partial remission, and three patients achieved stabilization of disease (no change). The median progression-free survival was 7.7 months (range, 2-15 months). Side effects generally were mild (World Health Organization Grade 1-2). Hospitalization was not necessary. CONCLUSIONS: This new triple combination of low-dose metronomic trofosfamide, pioglitazone, and rofecoxib may represent a feasible new alternative in the palliative treatment of patients with advanced malignant vascular tumors. |
| Databáze: | OpenAIRE |
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