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Metronomic Chemotherapy for Advanced Prostate Cancer: A Literature Review

Metastatic castration-resistant prostate cancer (mCRPC) is the ultimately lethal form of prostate cancer. Docetaxel chemotherapy was the first life-prolonging treatment for mCRPC; however, the standard maximally tolerated dose (MTD) docetaxel regimen is often not considered for patients with mCRPC w...

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Autores principales: Parshad, Shruti, Sidhu, Amanjot K., Khan, Nabeeha, Naoum, Andrew, Emmenegger, Urban
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147851/
https://www.ncbi.nlm.nih.gov/pubmed/35628909
http://dx.doi.org/10.3390/jcm11102783
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author Parshad, Shruti
Sidhu, Amanjot K.
Khan, Nabeeha
Naoum, Andrew
Emmenegger, Urban
author_facet Parshad, Shruti
Sidhu, Amanjot K.
Khan, Nabeeha
Naoum, Andrew
Emmenegger, Urban
author_sort Parshad, Shruti
collection PubMed
description Metastatic castration-resistant prostate cancer (mCRPC) is the ultimately lethal form of prostate cancer. Docetaxel chemotherapy was the first life-prolonging treatment for mCRPC; however, the standard maximally tolerated dose (MTD) docetaxel regimen is often not considered for patients with mCRPC who are older and/or frail due to its toxicity. Low-dose metronomic chemotherapy (LDMC) is the frequent administration of typically oral and off-patent chemotherapeutics at low doses, which is associated with a superior safety profile and higher tolerability than MTD chemotherapy. We conducted a systematic literature review using the PUBMED, EMBASE, and MEDLINE electronic databases to identify clinical studies that examined the impact of LDMC on patients with advanced prostate cancer. The search identified 30 reports that retrospectively or prospectively investigated LDMC, 29 of which focused on mCRPC. Cyclophosphamide was the most commonly used agent integrated into 27/30 (90%) of LDMC regimens. LDMC resulted in a clinical benefit rate of 56.8 ± 24.5% across all studies. Overall, there were only a few non-hematological grade 3 or 4 adverse events reported. As such, LDMC is a well-tolerated treatment option for patients with mCRPC, including those who are older and frail. Furthermore, LDMC is considered more affordable than conventional mCRPC therapies. However, prospective phase III trials are needed to further characterize the efficacy and safety of LDMC in mCRPC before its use in practice.
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spelling pubmed-91478512022-05-29 Metronomic Chemotherapy for Advanced Prostate Cancer: A Literature Review Parshad, Shruti Sidhu, Amanjot K. Khan, Nabeeha Naoum, Andrew Emmenegger, Urban J Clin Med Review Metastatic castration-resistant prostate cancer (mCRPC) is the ultimately lethal form of prostate cancer. Docetaxel chemotherapy was the first life-prolonging treatment for mCRPC; however, the standard maximally tolerated dose (MTD) docetaxel regimen is often not considered for patients with mCRPC who are older and/or frail due to its toxicity. Low-dose metronomic chemotherapy (LDMC) is the frequent administration of typically oral and off-patent chemotherapeutics at low doses, which is associated with a superior safety profile and higher tolerability than MTD chemotherapy. We conducted a systematic literature review using the PUBMED, EMBASE, and MEDLINE electronic databases to identify clinical studies that examined the impact of LDMC on patients with advanced prostate cancer. The search identified 30 reports that retrospectively or prospectively investigated LDMC, 29 of which focused on mCRPC. Cyclophosphamide was the most commonly used agent integrated into 27/30 (90%) of LDMC regimens. LDMC resulted in a clinical benefit rate of 56.8 ± 24.5% across all studies. Overall, there were only a few non-hematological grade 3 or 4 adverse events reported. As such, LDMC is a well-tolerated treatment option for patients with mCRPC, including those who are older and frail. Furthermore, LDMC is considered more affordable than conventional mCRPC therapies. However, prospective phase III trials are needed to further characterize the efficacy and safety of LDMC in mCRPC before its use in practice. MDPI 2022-05-15 /pmc/articles/PMC9147851/ /pubmed/35628909 http://dx.doi.org/10.3390/jcm11102783 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Parshad, Shruti
Sidhu, Amanjot K.
Khan, Nabeeha
Naoum, Andrew
Emmenegger, Urban
Metronomic Chemotherapy for Advanced Prostate Cancer: A Literature Review
title Metronomic Chemotherapy for Advanced Prostate Cancer: A Literature Review
title_full Metronomic Chemotherapy for Advanced Prostate Cancer: A Literature Review
title_fullStr Metronomic Chemotherapy for Advanced Prostate Cancer: A Literature Review
title_full_unstemmed Metronomic Chemotherapy for Advanced Prostate Cancer: A Literature Review
title_short Metronomic Chemotherapy for Advanced Prostate Cancer: A Literature Review
title_sort metronomic chemotherapy for advanced prostate cancer: a literature review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9147851/
https://www.ncbi.nlm.nih.gov/pubmed/35628909
http://dx.doi.org/10.3390/jcm11102783
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