Metronomic therapy has low toxicity and is as effective as current standard treatment for recurrent high-risk neuroblastoma

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BERTHOLD Frank HÖMBERG Marc PROLESKOVSKAJA Inna MAZÁNEK Pavel BELOGUROVA Margarita ERNST Angela ŠTĚRBA Jaroslav

Rok publikování 2017
Druh Článek v odborném periodiku
Časopis / Zdroj Pediatric Hematology and Oncology
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Doi http://dx.doi.org/10.1080/08880018.2017.1373314
Obor Onkologie a hematologie
Klíčová slova Angiogenesis; dose-intense chemotherapy; immunomodulation; metronomic therapy; neuroblastoma
Popis The metronomic therapy concept uses low doses of continuously applied chemotherapeutic, anti-angiogenetic, and immunomodulating drugs. Twenty patients with recurrent and 3 with refractory high-risk neuroblastoma were treated by the metronomic concept using celecoxib, cyclophosphamide, vinblastine, and etoposide for up to 24 months. The outcome was compared to 274 matched patients with a first recurrence from stage 4 neuroblastoma using the variables time from diagnosis to first recurrence, number of organs involved, and MYCN amplification. All were treated with dose-intensive conventional chemotherapy. The study patients experienced 1-3 recurrences and had 1-3 sites involved (osteomedullary, primary tumor, central nervous system, lymph nodes, liver, lungs) before the metronomic therapy started. Two patients in complete remission and three with active refractory disease following recurrence treatment were excluded from the outcome analysis. The curves for secondary event-free and overall survival demonstrated no significant differences.

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