Improved Long-Term Survival of Patients with Recurrent Medulloblastoma Treated with a “MEMMAT-like” Metronomic Antiangiogenic Approach
Medulloblastoma (MB) recurrence is usually incurable despite intensive therapy including high-dose chemotherapy. An evolving alternative approach to conventional chemotherapy aims at interfering with tumor angiogenesis at different levels. We report on a novel combinatorial metronomic antiangiogenic...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/20/5128 |
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| author | Irene Slavc Lisa Mayr Natalia Stepien Johannes Gojo Maria Aliotti Lippolis Amedeo A. Azizi Monika Chocholous Alicia Baumgartner Cora S. Hedrich Stefan Holm Astrid Sehested Pierre Leblond Karin Dieckmann Christine Haberler Thomas Czech Marcel Kool Andreas Peyrl |
| author_facet | Irene Slavc Lisa Mayr Natalia Stepien Johannes Gojo Maria Aliotti Lippolis Amedeo A. Azizi Monika Chocholous Alicia Baumgartner Cora S. Hedrich Stefan Holm Astrid Sehested Pierre Leblond Karin Dieckmann Christine Haberler Thomas Czech Marcel Kool Andreas Peyrl |
| author_sort | Irene Slavc |
| collection | DOAJ |
| description | Medulloblastoma (MB) recurrence is usually incurable despite intensive therapy including high-dose chemotherapy. An evolving alternative approach to conventional chemotherapy aims at interfering with tumor angiogenesis at different levels. We report on a novel combinatorial metronomic antiangiogenic approach. The study is a retrospective observational study of 29 consecutive patients with first or multiple recurrences prospectively treated according to the MEMMAT strategy (“MEMMAT-like”) before the formal protocol (MEMMAT; ClinicalTrials.gov Identifier: NCT01356290) started. The study period was 11/2006 to 06/2016. Treatment consisted of daily oral thalidomide, fenofibrate, celecoxib, and alternating 21-day cycles of low-dose oral etoposide and cyclophosphamide supplemented by IV bevacizumab and intraventricular therapy consisting of alternating etoposide and liposomal cytarabine. Median overall survival (OS) after recurrence for the whole group was 29.5 months, OS was 48.3 ± 9.3% at three years and 34.5 ± 8.8% at five years, and progression-free survival was 42.0 ± 9.5% at three years and 29.4 ± 9% at five years. As of 07/2022, 9/29 patients are alive 86 to 164 months after the recurrence that prompted the “MEMMAT-like” therapy. Treatment was primarily out-patient and generally well-tolerated. Toxicities did occur but were manageable. In conclusion, antiangiogenic therapy according to the MEMMAT strategy increased median OS of patients with recurrent MB and may lead to long-term survival. Adherence to the protocol, including intraventricular therapy, appears important. |
| first_indexed | 2024-03-09T20:30:56Z |
| format | Article |
| id | doaj.art-3967e403e9c24bd7a10c73b3d480d831 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T20:30:56Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-3967e403e9c24bd7a10c73b3d480d8312023-11-23T23:22:26ZengMDPI AGCancers2072-66942022-10-011420512810.3390/cancers14205128Improved Long-Term Survival of Patients with Recurrent Medulloblastoma Treated with a “MEMMAT-like” Metronomic Antiangiogenic ApproachIrene Slavc0Lisa Mayr1Natalia Stepien2Johannes Gojo3Maria Aliotti Lippolis4Amedeo A. Azizi5Monika Chocholous6Alicia Baumgartner7Cora S. Hedrich8Stefan Holm9Astrid Sehested10Pierre Leblond11Karin Dieckmann12Christine Haberler13Thomas Czech14Marcel Kool15Andreas Peyrl16Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, AustriaDepartment of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, AustriaDepartment of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, AustriaDepartment of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, AustriaDepartment of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, AustriaDepartment of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, AustriaDepartment of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, AustriaDepartment of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, AustriaDepartment of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, AustriaDepartment of Women’s and Children’s Health, Karolinska Institutet, 17177 Stockholm, SwedenDepartment of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, DenmarkInstitute of Pediatric Hematology and Oncology IHOPe, Léon Bérard Cancer Center, 69002 Lyon, FranceRadiation Oncology, Department of Radiotherapy, Medical University Vienna, 1090 Vienna, AustriaDivision of Neuropathology and Neurochemistry, Department of Neurology, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Neurosurgery, Medical University of Vienna, 1090 Vienna, AustriaHopp Children’s Cancer Center (KiTZ), 69120 Heidelberg, GermanyDepartment of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, AustriaMedulloblastoma (MB) recurrence is usually incurable despite intensive therapy including high-dose chemotherapy. An evolving alternative approach to conventional chemotherapy aims at interfering with tumor angiogenesis at different levels. We report on a novel combinatorial metronomic antiangiogenic approach. The study is a retrospective observational study of 29 consecutive patients with first or multiple recurrences prospectively treated according to the MEMMAT strategy (“MEMMAT-like”) before the formal protocol (MEMMAT; ClinicalTrials.gov Identifier: NCT01356290) started. The study period was 11/2006 to 06/2016. Treatment consisted of daily oral thalidomide, fenofibrate, celecoxib, and alternating 21-day cycles of low-dose oral etoposide and cyclophosphamide supplemented by IV bevacizumab and intraventricular therapy consisting of alternating etoposide and liposomal cytarabine. Median overall survival (OS) after recurrence for the whole group was 29.5 months, OS was 48.3 ± 9.3% at three years and 34.5 ± 8.8% at five years, and progression-free survival was 42.0 ± 9.5% at three years and 29.4 ± 9% at five years. As of 07/2022, 9/29 patients are alive 86 to 164 months after the recurrence that prompted the “MEMMAT-like” therapy. Treatment was primarily out-patient and generally well-tolerated. Toxicities did occur but were manageable. In conclusion, antiangiogenic therapy according to the MEMMAT strategy increased median OS of patients with recurrent MB and may lead to long-term survival. Adherence to the protocol, including intraventricular therapy, appears important.https://www.mdpi.com/2072-6694/14/20/5128medulloblastoma recurrenceantiangiogenic therapymetronomic therapylow-dose oral therapybevacizumabintraventricular therapy |
| spellingShingle | Irene Slavc Lisa Mayr Natalia Stepien Johannes Gojo Maria Aliotti Lippolis Amedeo A. Azizi Monika Chocholous Alicia Baumgartner Cora S. Hedrich Stefan Holm Astrid Sehested Pierre Leblond Karin Dieckmann Christine Haberler Thomas Czech Marcel Kool Andreas Peyrl Improved Long-Term Survival of Patients with Recurrent Medulloblastoma Treated with a “MEMMAT-like” Metronomic Antiangiogenic Approach Cancers medulloblastoma recurrence antiangiogenic therapy metronomic therapy low-dose oral therapy bevacizumab intraventricular therapy |
| title | Improved Long-Term Survival of Patients with Recurrent Medulloblastoma Treated with a “MEMMAT-like” Metronomic Antiangiogenic Approach |
| title_full | Improved Long-Term Survival of Patients with Recurrent Medulloblastoma Treated with a “MEMMAT-like” Metronomic Antiangiogenic Approach |
| title_fullStr | Improved Long-Term Survival of Patients with Recurrent Medulloblastoma Treated with a “MEMMAT-like” Metronomic Antiangiogenic Approach |
| title_full_unstemmed | Improved Long-Term Survival of Patients with Recurrent Medulloblastoma Treated with a “MEMMAT-like” Metronomic Antiangiogenic Approach |
| title_short | Improved Long-Term Survival of Patients with Recurrent Medulloblastoma Treated with a “MEMMAT-like” Metronomic Antiangiogenic Approach |
| title_sort | improved long term survival of patients with recurrent medulloblastoma treated with a memmat like metronomic antiangiogenic approach |
| topic | medulloblastoma recurrence antiangiogenic therapy metronomic therapy low-dose oral therapy bevacizumab intraventricular therapy |
| url | https://www.mdpi.com/2072-6694/14/20/5128 |
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