Retrospective study of metronomic chemotherapy in advanced NSCLC at a tertiary centre in south India
DOI:
https://doi.org/10.7439/ijbr.v10i1.4976Keywords:
Fish, Productivity, Isapur, MaharashtraAbstract
Background: Chemotherapy and immunotherapy are the backbone for treatment of most NSCLC (non small cell lung cancer). But many patients are not able to tolerate chemotherapy and not able to afford immunotherapy in our scenario. Objective: The aim of this retrospective study was to assess the clinical activity and toxicity profile of metronomic therapy with cyclophosphamide and etoposide in advanced NSCLC. Material and methods : Fifty patients were treated (20 treatment naive patients, 10 as second line therapy and 20 as maintenance therapy) between Feb 2015 and Feb 2018. Patients were given tab cyclophosphamide 50 mg once daily and Cap. Etoposide 50 mg alternate days continuously till disease progression. Patients were assessed for treatment response in the form of progression free survival. Results: The median age was 65 years. The median duration of treatment was 6 months. Response was seen in form of stable disease only, in 16 patients. Median progression free survival was 4 months in treatment naive, 7 months in setting of maintenance therapy and 3 months in second line setting. Conclusion: In resource limited setting, metronomic chemotherapy is useful in advanced NSCLC. This is an affordable regimen which has minimal toxicity with promising survival.Downloads
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References
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Morgensztern D, Ng SH, Gao F, Govindan R. Trends in stage distribution for patients with non-small cell lung cancer: a National Cancer Database survey. J Thorac Oncol. 2010 Jan; 5(1): 29-33.
Noronha V, Krishna MV, Patil V, Joshi A, Banavali SD, Prabhash K. Metronomic therapy: Chemotherapy revisited. Indian J Cancer 2013 Apr-Jun; 50(2):142-8.
Grunberg, S.M. Cyclophosphamide and etoposide for non-small cell and small cell lung cancer. Drugs. 1999 Nov; 58(3): 11-15.
Kosmidis PA, Syrigos K, Kalofonos HP, Dimopoulos MA, Skarlos D, Pavlidis N, Boukovinas I, Bafaloukos D, Pectasides D, Bacoyiannis C, Fountzilas G. Vinorelbine versus paclitaxel for patients with advanced non-small cell lung cancer (NSCLC) and a performance status of 2. Anticancer Res. 2012 Jan; 32(1):175-81.
Noronha V, Patil VM, Joshi A, Prabhash K.Efficacy and safety of metronomic administration of paclitaxel for advanced recurrent non-small-cell lung cancer. Indian J Cancer 2013 Apr-Jun; 50(2):122-7.
Camerini A, Puccetti C, Donati S, Valsuani C, Petrella MC, Tartarelli G, Puccinelli P, Amoroso D. Metronomic oral vinorelbine as first-line treatment in elderly patients with advanced non-small cell lung cancer: results of a phase II trial (MOVE trial). BMC Cancer 2015 May 6; 15:359.
[8]. BJ S., Lalkota B. P., Veldhore V. H., Rao R., Naik R. Efficacy study of metronomic chemotherapy in metastatic NSCLC and correlation with VEGF and Thrombospondin levels. WCRJ 2017; 4 (2): e878.
Kosmidis PA, Syrigos K, Kalofonos HP, Dimopoulos MA, Skarlos D, Pavlidis N, Boukovinas I, Bafaloukos D, Pectasides D, Bacoyiannis C, Fountzilas G. Vinorelbine versus paclitaxel for patients with advanced non-small cell lung cancer (NSCLC) and a performance status of 2. Anticancer Res. 2012 Jan; 32(1):175-81.
Barlesi F, Scherpereel A, Rittmeyer A, Pazzola A, Ferrer Tur N, Kim JH, Ahn MJ, Aerts JG, Gorbunova V, Vikström A, Wong EK, Perez-Moreno P, Mitchell L, Groen HJ. Randomized phase III trial of maintenance bevacizumab with or without pemetrexed after first-line induction with bevacizumab, cisplatin, and pemetrexed in advanced nonsquamous non-small-cell lung cancer: AVAPERL (MO22089). J Clin Oncol 2013 Aug 20; 31(24):3004-11.
Patel JD, Socinski MA, Garon EB, Reynolds CH, Spigel DR, Olsen MR, Hermann RC, Jotte RM, Beck T, Richards DA, Guba SC, Liu J, Frimodt-Moller B, John WJ, Obasaju CK, Pennella EJ, Bonomi P, Govindan R. Point Break: a randomized phase III study of pemetrexed plus carboplatin and bevacizumab followed by maintenance pemetrexed and bevacizumab versus paclitaxel plus carboplatin and bevacizumab followed by maintenance bevacizumab in patients with stage IIIB or IV nonsquamous non-small-cell lung cancer. J Clin Oncol. 2013 Dec 1; 31(34): 4349-57.
Pirker R., Pereira J., Szczesna A., Von Pawel J., Krzakowski M., Ramlau R., et al. Cetuximab plus chemotherapy in patients with advanced non-small-cell lung cancer (FLEX): an open-label randomised phase III trial. Lancet 2009; 373: 1525–1531
Paz-Ares LG, de Marinis F, Dediu M, Thomas M, Pujol JL, Bidoli P, Molinier O, Sahoo TP, Laack E, Reck M, Corral J, Melemed S, John W, Chouaki N, Zimmermann AH, Visseren-Grul C, Gridelli C. PARAMOUNT: Final overall survival results of the phase III study of maintenance pemetrexed versus placebo immediately after induction treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancer. J Clin Oncol. 2013 Aug 10; 31(23): 2895-902.
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2019-01-09
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Retrospective study of metronomic chemotherapy in advanced NSCLC at a tertiary centre in south India. Int Jour of Biomed Res [Internet]. 2019 Jan. 9 [cited 2025 Mar. 12];10(1):e4976. Available from: https://ssjournals.co.in/index.php/ijbr/article/view/4976