The metronomic therapy with prednisone, etoposide, and cyclophosphamide reduces the serum levels of VEGF and circulating endothelial cells and improves response rates and progression-free survival in patients with relapsed or refractory non-Hodgkin's lymphoma

Autor: Zhihui He, Liangxia Yang, Fen Huang, Yanda Lu, Junhua Lei, Tao Hong, Huamao Sun, Jiangzheng Zeng, Xinbao Hao
Rok vydání: 2016
Předmět:
0301 basic medicine
Oncology
Adult
Male
Vascular Endothelial Growth Factor A
Cancer Research
medicine.medical_specialty
Cyclophosphamide
Antineoplastic Agents
Hormonal
Toxicology
Disease-Free Survival
03 medical and health sciences
chemistry.chemical_compound
Young Adult
0302 clinical medicine
Refractory
Prednisone
Recurrence
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Pharmacology (medical)
Progression-free survival
Antineoplastic Agents
Alkylating
Etoposide
Aged
Pharmacology
business.industry
Lymphoma
Non-Hodgkin
Endothelial Cells
Middle Aged
Metronomic Chemotherapy
Antineoplastic Agents
Phytogenic
Vascular endothelial growth factor
Regimen
030104 developmental biology
chemistry
Drug Resistance
Neoplasm
030220 oncology & carcinogenesis
Administration
Metronomic
Female
business
medicine.drug
Zdroj: Cancer chemotherapy and pharmacology. 78(4)
ISSN: 1432-0843
Popis: There is an urgent need for a better strategy in the management of relapsed or refractory non-Hodgkin’s lymphoma (NHL). The present study was designed to evaluate the efficacy and safety of the regimen using metronomic prednisone, etoposide, and cyclophosphamide in the treatment of patients with relapsed or refractory NHL, in comparison with conventional salvage chemotherapy. Eligible patients were randomized to the test group (n = 23) receiving metronomic prednisone, etoposide, and cyclophosphamide or the control group (n = 21) receiving conventional salvage chemotherapy. The serum levels of circulating endothelial cells (CECs) and vascular endothelial growth factor (VEGF) were measured before and after two cycles of treatment; overall response rate (ORR) and disease control rate (DCR) were evaluated at cycles 2, 4, 6, and 12 months after treatment. After two cycles of treatment, the ORRs of the test and control groups were statistically similar, while the DCR of the test group (87.0 %) was significantly higher than that of the control group (57.1 %). At 12 months after treatment, the ORR and DCR of the test group (47.8 and 69.6 %, respectively) were significantly higher than that of the control group (19.0 and 33.3 %, respectively). The serum CECs and VEGF levels in the test group after treatment were significantly lower than that before treatment or that of the control group. In the patients with ORR and DCR in the test group, the serum CECs and VEGF levels remained relatively low at cycles 2, 4, and 6 and at 12 months after treatment. There was a progression-free survival (PFS) benefit of 6.5 months in the test group, compared with the control group. Metronomic chemotherapy with prednisone, etoposide, and cyclophosphamide resulted in higher ORR and DCR, fewer adverse effects, and longer PFS in patients with relapsed or refractory NHL, with significant reduction in serum CECs and VEGF levels.
Databáze: OpenAIRE
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