Universität zu Köln

Berthold, Frank, Hoemberg, Marc, Proleskovskaya, Inna, Mazanek, Pavel, Belogurova, Margarita, Ernst, Angela ORCID: 0000-0003-2375-1889 and Sterba, Jaroslav (2017). Metronomic therapy has low toxicity and is as effective as current standard treatment for recurrent high-risk neuroblastoma. Pediatr. Hematol. Oncol., 34 (5). S. 308 - 320. PHILADELPHIA: TAYLOR & FRANCIS INC. ISSN 1521-0669

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Abstract

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 24months. 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. The toxicity was minimal except for 3 grade thrombocytopenia and leukopenia (all heavily pretreated). The treatment was realized in an outpatient setting. The metronomic approach is similarly effective as standard treatment in recurrent high-risk neuroblastoma, has low toxicity, and is applicable in an outpatient setting. A prospective study including propranolol as a fifth drug is underway.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Berthold, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoemberg, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Proleskovskaya, Inna UNSPECIFIED UNSPECIFIED UNSPECIFIED Mazanek, Pavel UNSPECIFIED UNSPECIFIED UNSPECIFIED Belogurova, Margarita UNSPECIFIED UNSPECIFIED UNSPECIFIED Ernst, Angela UNSPECIFIED orcid.org/0000-0003-2375-1889 UNSPECIFIED Sterba, Jaroslav UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-244093
DOI:	10.1080/08880018.2017.1373314
Journal or Publication Title:	Pediatr. Hematol. Oncol.
Volume:	34
Number:	5
Page Range:	S. 308 - 320
Date:	2017
Publisher:	TAYLOR & FRANCIS INC
Place of Publication:	PHILADELPHIA
ISSN:	1521-0669
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CELLS; MACROPHAGES; VINBLASTINE; M1; M2 Multiple languages Oncology; Hematology; Pediatrics Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24409