Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Feb 7;15(4):1067.
doi: 10.3390/cancers15041067.

Metronomic Chemotherapy Based on Topotecan or Topotecan and Cyclophosphamide Combination (CyTo) in Advanced, Pretreated Ovarian Cancer

Piotr J Wysocki  1   2 , Mateusz Łobacz  1 , Paweł Potocki  1   2 , Łukasz Kwinta  1   2 , Anna Michałowska-Kaczmarczyk  1   2 , Agnieszka Słowik  1 , Kamil Konopka  1   2 , Anna Buda-Nowak  1
Affiliations

Metronomic Chemotherapy Based on Topotecan or Topotecan and Cyclophosphamide Combination (CyTo) in Advanced, Pretreated Ovarian Cancer

Piotr J Wysocki et al. Cancers (Basel). .

Abstract

Patients with advanced ovarian cancer (OC) have a detrimental prognosis. The options for systemic treatment of advanced OC in later lines of treatment are limited by the availability of active therapies and their applicability to often fragile, exhausted patients with poor performance status. Metronomic chemotherapy (MC) is a concept of a continuous administration of cytotoxic drugs, which is characterized by multidirectional activity (anti-proliferative, anti-angiogenic, and anti-immunosuppressive) and low toxicity. We have performed a retrospective analysis of consecutive, advanced, chemo-refractory OC patients treated with MC based on single-agent topotecan (1 mg p.o. q2d) or on a topotecan (1 mg q2d) and cyclophosphamide (50 mg p.o. qd) combination (CyTo). Metronomic chemotherapy demonstrated promising activity, with 72% and 86% of patients achieving biochemical or objective disease control and 18% and 27% of patients achieving a biochemical or objective response, respectively. The median PFS in the whole population was 3.65 months, but the median PFS in patients with a biochemical response to MC (18.2% of patients) reached 10.7 months. The study also suggested that overweight or obese patients had significantly better outcomes on MC than patients with BMI <25 kg/m2. This article is the first report in the literature on metronomic chemotherapy based on a topotecan + cyclophosphamide combination (CyTo). The CyTo regimen demonstrated safety, clinical activity, and potential broad clinical applicability in advanced OC patients and will be evaluated in a forthcoming clinical trial.

Keywords: BMI; metronomic chemotherapy; ovarian cancer; salvage treatment; topotecan; topotecan + cyclophosphamide.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Analysis of responses. (a) Responses according to RECIST 1.1 criteria—CR—complete response; PR—partial response; SD—disease stabilization, PD—progressive disease. (b) Biochemical responses according to GCIG guidelines—bCR—biochemical complete response; bPR -biochemical partial response; pSD—biochemical stabilization; bPD—biochemical progression.
Figure 2
Figure 2
Progression-free survival (a) in the whole population; (b) in patients treated with single-agent topotecan and topotecan + cyclophosphamide (CyTo) combination.
Figure 3
Figure 3
Progression-free survival (a) according to histology; (b) according to tumor grade; (c) according to platinum-sensitivity, (d) according to the number of lines of previous systemic treatment.
Figure 4
Figure 4
Progression-free survival according to (a) biochemical response, (b) BMI.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Torre L.A., Trabert B., DeSantis C.E., Miller K.D., Samimi G., Runowicz C.D., Gaudet M.M., Jemal A., Siegel R.L. Ovarian Cancer Statistics, 2018. CA Cancer J. Clin. 2018;68:284. doi: 10.3322/caac.21456. - DOI - PMC - PubMed
    1. Cancer Registration Statistics, England Statistical Bulletins—Office for National Statistics. [(accessed on 28 December 2022)]; Available online: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/....
    1. Dion L., Mimoun C., Timoh K.N., Bendifallah S., Bricou A., Collinet P., Touboul C., Ouldamer L., Azaïs H., Dabi Y., et al. Ovarian Cancer in the Elderly: Time to Move towards a More Logical Approach to Improve Prognosis—A Study from the FRANCOGYN Group. J. Clin. Med. 2020;9:1339. doi: 10.3390/jcm9051339. - DOI - PMC - PubMed
    1. Tew W.P. Ovarian Cancer in the Older Woman. J. Geriatr. Oncol. 2016;7:354–361. doi: 10.1016/j.jgo.2016.07.008. - DOI - PubMed
    1. Pignata S., Ballatori E., Favalli G., Scambia G. Quality of Life: Gynaecological Cancers. Ann. Oncol. 2001;12:37–42. doi: 10.1093/annonc/12.suppl_3.S37. - DOI - PubMed

LinkOut - more resources