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Retrospective National “Real Life” Experience of the SFCE with the Metronomic MEMMAT and MEMMAT-like Protocol

Background: Relapses in pediatric high-risk brain tumors remain unmet medical needs. Over the last 15 years, metronomic chemotherapy has gradually emerged as an alternative therapeutic approach. Patients and Methods: This is a national retrospective study of patients with relapsing pediatric brain t...

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Autores principales: Winnicki, Camille, Leblond, Pierre, Bourdeaut, Franck, Pagnier, Anne, Paluenzela, Gilles, Chastagner, Pascal, Duhil-De Benaze, Gwenaelle, Min, Victoria, Sudour-Bonnange, Hélène, Piette, Catherine, Entz-Werle, Natacha, Chabaud, Sylvie, André, Nicolas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967517/
https://www.ncbi.nlm.nih.gov/pubmed/36835950
http://dx.doi.org/10.3390/jcm12041415
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author Winnicki, Camille
Leblond, Pierre
Bourdeaut, Franck
Pagnier, Anne
Paluenzela, Gilles
Chastagner, Pascal
Duhil-De Benaze, Gwenaelle
Min, Victoria
Sudour-Bonnange, Hélène
Piette, Catherine
Entz-Werle, Natacha
Chabaud, Sylvie
André, Nicolas
author_facet Winnicki, Camille
Leblond, Pierre
Bourdeaut, Franck
Pagnier, Anne
Paluenzela, Gilles
Chastagner, Pascal
Duhil-De Benaze, Gwenaelle
Min, Victoria
Sudour-Bonnange, Hélène
Piette, Catherine
Entz-Werle, Natacha
Chabaud, Sylvie
André, Nicolas
author_sort Winnicki, Camille
collection PubMed
description Background: Relapses in pediatric high-risk brain tumors remain unmet medical needs. Over the last 15 years, metronomic chemotherapy has gradually emerged as an alternative therapeutic approach. Patients and Methods: This is a national retrospective study of patients with relapsing pediatric brain tumors treated according to the MEMMAT or MEMMAT-like regimen from 2010 to 2022. Treatment consisted of daily oral thalidomide, fenofibrate, and celecoxib, and alternating 21-day cycles of metronomic etoposide and cyclophosphamide associated with bevacizumab and intraventricular chemotherapy. Results: Forty-one patients were included. The most frequent malignancies were medulloblastoma (22) and ATRT (8). Overall, the best responses were CR in eight patients (20%), PR in three patients (7%), and SD in three patients (7%), for a clinical benefit rate of 34%. The median overall survival was 26 months (IC95% = 12.4–42.7), and median EFS was 9.7 months (IC95% = 6.0–18.6). The most frequent grade ¾ toxicities were hematological. Dose had to be adjusted in 27% of the cases. There was no statistical difference in outcome between full or modified MEMMAT. The best setting seems to be when MEMMAT is used as a maintenance and at first relapse. Conclusions: The metronomic MEMMAT combination can lead to sustained control of relapsed high-risk pediatric brain tumors.
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spelling pubmed-99675172023-02-27 Retrospective National “Real Life” Experience of the SFCE with the Metronomic MEMMAT and MEMMAT-like Protocol Winnicki, Camille Leblond, Pierre Bourdeaut, Franck Pagnier, Anne Paluenzela, Gilles Chastagner, Pascal Duhil-De Benaze, Gwenaelle Min, Victoria Sudour-Bonnange, Hélène Piette, Catherine Entz-Werle, Natacha Chabaud, Sylvie André, Nicolas J Clin Med Article Background: Relapses in pediatric high-risk brain tumors remain unmet medical needs. Over the last 15 years, metronomic chemotherapy has gradually emerged as an alternative therapeutic approach. Patients and Methods: This is a national retrospective study of patients with relapsing pediatric brain tumors treated according to the MEMMAT or MEMMAT-like regimen from 2010 to 2022. Treatment consisted of daily oral thalidomide, fenofibrate, and celecoxib, and alternating 21-day cycles of metronomic etoposide and cyclophosphamide associated with bevacizumab and intraventricular chemotherapy. Results: Forty-one patients were included. The most frequent malignancies were medulloblastoma (22) and ATRT (8). Overall, the best responses were CR in eight patients (20%), PR in three patients (7%), and SD in three patients (7%), for a clinical benefit rate of 34%. The median overall survival was 26 months (IC95% = 12.4–42.7), and median EFS was 9.7 months (IC95% = 6.0–18.6). The most frequent grade ¾ toxicities were hematological. Dose had to be adjusted in 27% of the cases. There was no statistical difference in outcome between full or modified MEMMAT. The best setting seems to be when MEMMAT is used as a maintenance and at first relapse. Conclusions: The metronomic MEMMAT combination can lead to sustained control of relapsed high-risk pediatric brain tumors. MDPI 2023-02-10 /pmc/articles/PMC9967517/ /pubmed/36835950 http://dx.doi.org/10.3390/jcm12041415 Text en © 2023 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 Article
Winnicki, Camille
Leblond, Pierre
Bourdeaut, Franck
Pagnier, Anne
Paluenzela, Gilles
Chastagner, Pascal
Duhil-De Benaze, Gwenaelle
Min, Victoria
Sudour-Bonnange, Hélène
Piette, Catherine
Entz-Werle, Natacha
Chabaud, Sylvie
André, Nicolas
Retrospective National “Real Life” Experience of the SFCE with the Metronomic MEMMAT and MEMMAT-like Protocol
title Retrospective National “Real Life” Experience of the SFCE with the Metronomic MEMMAT and MEMMAT-like Protocol
title_full Retrospective National “Real Life” Experience of the SFCE with the Metronomic MEMMAT and MEMMAT-like Protocol
title_fullStr Retrospective National “Real Life” Experience of the SFCE with the Metronomic MEMMAT and MEMMAT-like Protocol
title_full_unstemmed Retrospective National “Real Life” Experience of the SFCE with the Metronomic MEMMAT and MEMMAT-like Protocol
title_short Retrospective National “Real Life” Experience of the SFCE with the Metronomic MEMMAT and MEMMAT-like Protocol
title_sort retrospective national “real life” experience of the sfce with the metronomic memmat and memmat-like protocol
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9967517/
https://www.ncbi.nlm.nih.gov/pubmed/36835950
http://dx.doi.org/10.3390/jcm12041415
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