Metronomic chemotherapy with the COMBAT regimen in advanced pediatric malignancies: a multicenter experience
Jazyk angličtina Země Švýcarsko Médium print-electronic
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
22538363
DOI
10.1159/000336483
PII: 000336483
Knihovny.cz E-zdroje
- MeSH
- celekoxib MeSH
- dakarbazin aplikace a dávkování analogy a deriváty MeSH
- dítě MeSH
- dospělí MeSH
- etoposid aplikace a dávkování MeSH
- fenofibrát aplikace a dávkování MeSH
- inhibitory angiogeneze aplikace a dávkování MeSH
- isotretinoin aplikace a dávkování MeSH
- kojenec MeSH
- lidé MeSH
- metronomické podávání léků MeSH
- mladiství MeSH
- mladý dospělý MeSH
- nádory farmakoterapie MeSH
- předškolní dítě MeSH
- protokoly antitumorózní kombinované chemoterapie aplikace a dávkování MeSH
- pyrazoly aplikace a dávkování MeSH
- registrace * MeSH
- studie proveditelnosti MeSH
- sulfonamidy aplikace a dávkování MeSH
- temozolomid MeSH
- vitamin D aplikace a dávkování MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Evropa MeSH
- Názvy látek
- celekoxib MeSH
- dakarbazin MeSH
- etoposid MeSH
- fenofibrát MeSH
- inhibitory angiogeneze MeSH
- isotretinoin MeSH
- pyrazoly MeSH
- sulfonamidy MeSH
- temozolomid MeSH
- vitamin D MeSH
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.
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