Metronomic chemotherapy with the COMBAT regimen in advanced pediatric malignancies: a multicenter experience
| Autor: | Danica Zapletalová, Michael Doubek, Peter Múdry, Nicolas André, Dalibor Valík, K. Husek, Zdeněk Pavelka, Karel Zitterbart, Lucia Kútniková, Jarmila Skotáková, Tomáš Kepák, L. Deak, Regina Demlová, Michal Kyr, Alexandra Martinčeková, Viera Bajčiová, Lenka Zdražilová Dubská, Jaroslav Sterba, Pavel Mazánek |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Cancer Research Angiogenesis Inhibitors 0302 clinical medicine Fenofibrate Neoplasms Antineoplastic Combined Chemotherapy Protocols Registries Vitamin D Child Isotretinoin Etoposide 0303 health sciences Sulfonamides General Medicine 3. Good health Dacarbazine Europe Oncology 030220 oncology & carcinogenesis Child Preschool Female medicine.drug Adult medicine.medical_specialty Adolescent 03 medical and health sciences Young Adult Refractory Internal medicine medicine Vitamin D and neurology Temozolomide Humans 030304 developmental biology business.industry Infant medicine.disease Metronomic Chemotherapy Surgery Regimen Celecoxib Administration Metronomic Feasibility Studies Pyrazoles business Progressive disease |
| Zdroj: | Oncology. 82(5) |
| ISSN: | 1423-0232 |
| Popis: | Background: The outcome of children with refractory/relapsed malignancies remains poor and novel therapies are urgently required. One of the promising approaches is metronomic chemotherapy. We present the clinical results of 74 children with advanced solid tumors treated according to treatment recommendation with data registry in three European pediatric centers. Methods: COMBAT (Combined Oral Metronomic Biodifferentiating Antiangiogenic Treatment) included low-dose daily temozolomide, etoposide, celecoxib, vitamin D, fenofibrate and retinoic acid. From 2004 to 2010, 74 children were enrolled. Results: The 2-year overall survival (OS) was 43.1% (median 15.4, range 1.3–69.9 months). Of the 74 patients, 50 patients (68%) died and 24 are alive: 6 (8%) with progressive disease, 7 (9%) with stable disease/partial response and 11 (15%) in complete response. Median time to response was 6 months. Of 62 patients with initially measurable disease, 25 (40%) had radiological response or stable disease. Fourteen of 25 showing clinical benefit responded within the first 6 months. The treatment was well tolerated on an outpatient basis. Regarding non-hematological toxicity of grade ≥2, hepatotoxicity of grade 3 occurred in 8 children and grade 3 cheilitis in 16 children. Conclusion: COMBAT is a feasible and effective treatment option for patients with relapsing/refractory malignancies. The treatment is well tolerated with a low acute toxicity profile. |
| Databáze: | OpenAIRE |
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