Metronomic Etoposide/Cyclophosphamide/Celecoxib Regimen Given to Children and Adolescents with Refractory Cancer : A Preliminary Monocentric Study
Identifieur interne : 008B91 ( Main/Exploration ); précédent : 008B90; suivant : 008B92Metronomic Etoposide/Cyclophosphamide/Celecoxib Regimen Given to Children and Adolescents with Refractory Cancer : A Preliminary Monocentric Study
Auteurs : Nicolas Andre [France] ; Angelique Rome [France] ; Carole Coze [France] ; Laetitia Padovani [France] ; Eddy Pasquier [France, Australie] ; Laurence Camoin [France] ; Jean Claude Gentet [France]Source :
- Clinical therapeutics [ 0149-2918 ] ; 2008.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Enfant.
English descriptors
- KwdEn :
Abstract
Background: Metronomic chemotherapy (MC) is the administration of chemotherapy at doses below the maximal tolerated dose on a frequent schedule of administration, with no prolonged drug-free breaks. Objective: The aim of this research was to assess the effectiveness and tolerance of a metronomic etoposide/ cyclophosphamide/celecoxib regimen in children and adolescents with refractory cancer. Methods: This retrospective, single-center study evaluated the use of MC with etoposide 25 mg/m2. d-1 (days 1-14), cyclophosphamide 25 mg/m2. d-1 (days 15-28), and celecoxib 100 to 400 mg/d (days 1-28), in children with refractory, or high-risk relapsing, cancer. Adverse events were determined through laboratory analyses and investigator observations. Results: From January 2005 to December 2007, 17 children and adolescents were treated. The best responses observed were stabilizations of the disease that lasted over 20 weeks in 7 patients (41%). Most importantly, in 4 patients (24%) antalgic treatment could be transiently diminished or stopped, and in 1 patient (6%) oxygen support could be stopped for several weeks. Four grade IV platelet toxicities were noted in 3 patients; 2 grade IV anemia occurred in 2 patients (who had platelet and red blood cell transfusions before initiation of treatment); and 1 patient had grade III neutropenia. No other grade III or IV toxicities were noted. Grade II alopecia and stomatitis were observed in 1 patient and grade II vomiting was observed in 2 patients. One patient with meningeal carcinomatosis developed bilateral subdural hematoma for which the role of MC could not be ruled out. Circulating endothelial cells were elevated in 3 out of 3 patients in whom they were quantified and who were progressing while under MC. Conclusion: The MC regimen we report here was associated with disease stabilization without major toxicities. This assessment of MC in children and adolescents warrants further studies.
Affiliations:
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<author><name sortKey="Padovani, Laetitia" sort="Padovani, Laetitia" uniqKey="Padovani L" first="Laetitia" last="Padovani">Laetitia Padovani</name>
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</placeName>
</affiliation>
</author>
<author><name sortKey="Pasquier, Eddy" sort="Pasquier, Eddy" uniqKey="Pasquier E" first="Eddy" last="Pasquier">Eddy Pasquier</name>
<affiliation wicri:level="4"><inist:fA14 i1="02"><s1>INSERM UMR-777, CISMET (Cytosquelette et Intégration des Signaux du Micro-Environnement Tumoral), CRO2, Université d'Aix-Marseille</s1>
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<settlement type="city">Marseille</settlement>
</placeName>
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<s2>Randwick</s2>
<s3>AUS</s3>
<sZ>5 aut.</sZ>
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<country>Australie</country>
<wicri:noRegion>Randwick</wicri:noRegion>
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<author><name sortKey="Camoin, Laurence" sort="Camoin, Laurence" uniqKey="Camoin L" first="Laurence" last="Camoin">Laurence Camoin</name>
<affiliation wicri:level="3"><inist:fA14 i1="05"><s1>Laboratoire d'hématologie, Hôpital de la Conception</s1>
<s2>Marseille</s2>
<s3>FRA</s3>
<sZ>6 aut.</sZ>
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<placeName><region type="region">Provence-Alpes-Côte d'Azur</region>
<region type="old region">Provence-Alpes-Côte d'Azur</region>
<settlement type="city">Marseille</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Gentet, Jean Claude" sort="Gentet, Jean Claude" uniqKey="Gentet J" first="Jean Claude" last="Gentet">Jean Claude Gentet</name>
<affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Service d'Oncologie Pédiatrique, Hôpital pour Enfants de La Timone</s1>
<s2>Marseille</s2>
<s3>FRA</s3>
<sZ>1 aut.</sZ>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
<sZ>7 aut.</sZ>
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<placeName><region type="region">Provence-Alpes-Côte d'Azur</region>
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<settlement type="city">Marseille</settlement>
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<series><title level="j" type="main">Clinical therapeutics</title>
<title level="j" type="abbreviated">Clin. ther.</title>
<idno type="ISSN">0149-2918</idno>
<imprint><date when="2008">2008</date>
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<seriesStmt><title level="j" type="main">Clinical therapeutics</title>
<title level="j" type="abbreviated">Clin. ther.</title>
<idno type="ISSN">0149-2918</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term>
<term>Antineoplastic agent</term>
<term>Cancerology</term>
<term>Celecoxib</term>
<term>Child</term>
<term>Cyclophosphamide</term>
<term>Endothelial cell</term>
<term>Etoposide</term>
<term>Malignant tumor</term>
<term>Metronomic chemotherapy</term>
<term>Non steroidal antiinflammatory agent</term>
<term>Therapeutic protocol</term>
<term>Treatment resistance</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Etoposide</term>
<term>Cyclophosphamide</term>
<term>Anticancéreux</term>
<term>Célécoxib</term>
<term>Protocole thérapeutique</term>
<term>Enfant</term>
<term>Adolescent</term>
<term>Résistance traitement</term>
<term>Tumeur maligne</term>
<term>Cancérologie</term>
<term>Cellule endothéliale</term>
<term>Antiinflammatoire non stéroïde</term>
<term>Gène sis</term>
<term>Chimiothérapie métronomique</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Enfant</term>
</keywords>
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<front><div type="abstract" xml:lang="en">Background: Metronomic chemotherapy (MC) is the administration of chemotherapy at doses below the maximal tolerated dose on a frequent schedule of administration, with no prolonged drug-free breaks. Objective: The aim of this research was to assess the effectiveness and tolerance of a metronomic etoposide/ cyclophosphamide/celecoxib regimen in children and adolescents with refractory cancer. Methods: This retrospective, single-center study evaluated the use of MC with etoposide 25 mg/m<sup>2</sup>
. d<sup>-1</sup>
(days 1-14), cyclophosphamide 25 mg/m<sup>2</sup>
. d<sup>-1</sup>
(days 15-28), and celecoxib 100 to 400 mg/d (days 1-28), in children with refractory, or high-risk relapsing, cancer. Adverse events were determined through laboratory analyses and investigator observations. Results: From January 2005 to December 2007, 17 children and adolescents were treated. The best responses observed were stabilizations of the disease that lasted over 20 weeks in 7 patients (41%). Most importantly, in 4 patients (24%) antalgic treatment could be transiently diminished or stopped, and in 1 patient (6%) oxygen support could be stopped for several weeks. Four grade IV platelet toxicities were noted in 3 patients; 2 grade IV anemia occurred in 2 patients (who had platelet and red blood cell transfusions before initiation of treatment); and 1 patient had grade III neutropenia. No other grade III or IV toxicities were noted. Grade II alopecia and stomatitis were observed in 1 patient and grade II vomiting was observed in 2 patients. One patient with meningeal carcinomatosis developed bilateral subdural hematoma for which the role of MC could not be ruled out. Circulating endothelial cells were elevated in 3 out of 3 patients in whom they were quantified and who were progressing while under MC. Conclusion: The MC regimen we report here was associated with disease stabilization without major toxicities. This assessment of MC in children and adolescents warrants further studies.</div>
</front>
</TEI>
<affiliations><list><country><li>Australie</li>
<li>France</li>
</country>
<region><li>Provence-Alpes-Côte d'Azur</li>
</region>
<settlement><li>Marseille</li>
</settlement>
<orgName><li>Université d'Aix-Marseille</li>
</orgName>
</list>
<tree><country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Andre, Nicolas" sort="Andre, Nicolas" uniqKey="Andre N" first="Nicolas" last="Andre">Nicolas Andre</name>
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<name sortKey="Andre, Nicolas" sort="Andre, Nicolas" uniqKey="Andre N" first="Nicolas" last="Andre">Nicolas Andre</name>
<name sortKey="Camoin, Laurence" sort="Camoin, Laurence" uniqKey="Camoin L" first="Laurence" last="Camoin">Laurence Camoin</name>
<name sortKey="Coze, Carole" sort="Coze, Carole" uniqKey="Coze C" first="Carole" last="Coze">Carole Coze</name>
<name sortKey="Gentet, Jean Claude" sort="Gentet, Jean Claude" uniqKey="Gentet J" first="Jean Claude" last="Gentet">Jean Claude Gentet</name>
<name sortKey="Padovani, Laetitia" sort="Padovani, Laetitia" uniqKey="Padovani L" first="Laetitia" last="Padovani">Laetitia Padovani</name>
<name sortKey="Pasquier, Eddy" sort="Pasquier, Eddy" uniqKey="Pasquier E" first="Eddy" last="Pasquier">Eddy Pasquier</name>
<name sortKey="Rome, Angelique" sort="Rome, Angelique" uniqKey="Rome A" first="Angelique" last="Rome">Angelique Rome</name>
</country>
<country name="Australie"><noRegion><name sortKey="Pasquier, Eddy" sort="Pasquier, Eddy" uniqKey="Pasquier E" first="Eddy" last="Pasquier">Eddy Pasquier</name>
</noRegion>
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