Role of metronomic therapy for advanced oral cancers and predictors of response: Multi-institutional feasibility study.

Abstract

BACKGROUND:

In an era of targeted therapies, patients with cancer in resource-constraint countries continue to struggle to find affordable care.

METHODS:

The present study is a multicenter prospective single-arm study. Patients with expected delay in surgery, unresectable or metastatic cancers, and patients not suitable for surgery or conventional chemotherapy were included. Oral methotrexate 15 mg/m2 once a week and oral celecoxib 200 mg twice daily was used for metronomic therapy.

RESULTS:

At 8 weeks, a clinically complete response was seen in 2.5%, partial response in 46.6%, stable disease in 39.8%, and disease progression in 11%. Size less than 4 cm, alveolobuccal subsite, and well-differentiated histology were significantly associated with no disease progression.

CONCLUSION:

Constraint-adapted approach of using methotrexate and celecoxib is economical with good compliance, minimal toxicity, and good efficacy. It is feasible for use in diverse settings. Individualized selection of patients based on response predictors may maximize metronomic therapy's benefit.

• Authors: Mahesh Sultania, Mohammed Imaduddin, Suryanarayana S V Deo, Madhabananda Kar, Dillip K Muduly, Sunil Kumar, Atul Sharma, Ashutosh Mishra, Saroj K D Majumdar, Amit K Adhya, Dilip K Parida
• Journal: Head & neck (Head Neck) Vol. 44 Issue 1 Pg. 104-112 (01 2022) ISSN: 1097-0347 [Electronic] United States
• PMID: 34708450 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2021 Wiley Periodicals LLC.

Chemical References

• Cyclophosphamide
• Celecoxib

Topics

• Antineoplastic Combined Chemotherapy Protocols
• Celecoxib (therapeutic use)
• Cyclophosphamide (therapeutic use)
• Feasibility Studies
• Humans
• Mouth Neoplasms (drug therapy)
• Prospective Studies