Metronomic Cyclophosphamide and Methotrexate Chemotherapy Combined with 1E10 Anti-Idiotype Vaccine in Metastatic Breast Cancer

The use of low doses of cytotoxic agents continuously for prolonged periods is an alternative for the treatment of patients with metastatic breast cancer who have developed resistance to conventional chemotherapy. The combination of metronomic chemotherapy with therapeutic vaccines might increase th...

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Main Authors: Jorge L. Soriano, Noyde Batista, Eduardo Santiesteban, Mayté Lima, Joaquín González, Robin García, Yohanka Zarza, María V. López, Myriam Rodríguez, Jorge L. Loys, Narciso Montejo, Frank Aguirre, Amparo Macías, Ana M. Vázquez
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:International Journal of Breast Cancer
Online Access:http://dx.doi.org/10.4061/2011/710292
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author Jorge L. Soriano
Noyde Batista
Eduardo Santiesteban
Mayté Lima
Joaquín González
Robin García
Yohanka Zarza
María V. López
Myriam Rodríguez
Jorge L. Loys
Narciso Montejo
Frank Aguirre
Amparo Macías
Ana M. Vázquez
author_facet Jorge L. Soriano
Noyde Batista
Eduardo Santiesteban
Mayté Lima
Joaquín González
Robin García
Yohanka Zarza
María V. López
Myriam Rodríguez
Jorge L. Loys
Narciso Montejo
Frank Aguirre
Amparo Macías
Ana M. Vázquez
author_sort Jorge L. Soriano
collection DOAJ
description The use of low doses of cytotoxic agents continuously for prolonged periods is an alternative for the treatment of patients with metastatic breast cancer who have developed resistance to conventional chemotherapy. The combination of metronomic chemotherapy with therapeutic vaccines might increase the efficacy of the treatment. Twenty one patients with metastatic breast cancer in progression and a Karnosky index ≥60%, were treated with metronomic chemotherapy (50 mg of cyclophospamide orally daily and 2.5 mg of methotrexate orally bi-daily), in combination with five bi-weekly subcutaneous injections of 1 mg of aluminum hydroxide-precipitated 1E10 anti-idiotype MAb (1E10-Alum), followed by reimmunizations every 28 days. Five patients achieved objective response, eight showed stable disease and eight had disease progression. Median time to progression was 9,8 months, while median overall survival time was 12,93 months. The median duration of the response (CR+PR+SD) was 18,43 months (12,20–24,10 months), being higher than 12 months in 76,9% of the patients. Overall toxicity was generally mild. Metronomic chemotherapy combined with 1E10-Alum vaccine immunotherapy might be a useful therapeutic option for the treatment of metastatic breast cancer due to its potential impact on survival and patient quality of live, low toxicity and advantages of the administration.
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issn 2090-3189
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spelling doaj-art-e359d622d6774569a92324148303fbb72025-02-03T07:24:53ZengWileyInternational Journal of Breast Cancer2090-31892011-01-01201110.4061/2011/710292710292Metronomic Cyclophosphamide and Methotrexate Chemotherapy Combined with 1E10 Anti-Idiotype Vaccine in Metastatic Breast CancerJorge L. Soriano0Noyde Batista1Eduardo Santiesteban2Mayté Lima3Joaquín González4Robin García5Yohanka Zarza6María V. López7Myriam Rodríguez8Jorge L. Loys9Narciso Montejo10Frank Aguirre11Amparo Macías12Ana M. Vázquez13Oncology Service, Hermanos Amejeiras Hospital, Havana 10300, CubaOncology Service, Hermanos Amejeiras Hospital, Havana 10300, CubaOncology Service, José R. López Tabrane Hospital, Matanzas 40100, CubaOncology Service, Hermanos Amejeiras Hospital, Havana 10300, CubaOncology Service, Hermanos Amejeiras Hospital, Havana 10300, CubaOncology Service, Hermanos Amejeiras Hospital, Havana 10300, CubaOncology Service, Hermanos Amejeiras Hospital, Havana 10300, CubaOncology Service, Hermanos Amejeiras Hospital, Havana 10300, CubaOncology Service, Hermanos Amejeiras Hospital, Havana 10300, CubaOncology Service, Hermanos Amejeiras Hospital, Havana 10300, CubaOncology Service, Hermanos Amejeiras Hospital, Havana 10300, CubaOncology Service, José R. López Tabrane Hospital, Matanzas 40100, CubaClinical Division, Center of Molecular Immunology, Havana 11600, CubaClinical Division, Center of Molecular Immunology, Havana 11600, CubaThe use of low doses of cytotoxic agents continuously for prolonged periods is an alternative for the treatment of patients with metastatic breast cancer who have developed resistance to conventional chemotherapy. The combination of metronomic chemotherapy with therapeutic vaccines might increase the efficacy of the treatment. Twenty one patients with metastatic breast cancer in progression and a Karnosky index ≥60%, were treated with metronomic chemotherapy (50 mg of cyclophospamide orally daily and 2.5 mg of methotrexate orally bi-daily), in combination with five bi-weekly subcutaneous injections of 1 mg of aluminum hydroxide-precipitated 1E10 anti-idiotype MAb (1E10-Alum), followed by reimmunizations every 28 days. Five patients achieved objective response, eight showed stable disease and eight had disease progression. Median time to progression was 9,8 months, while median overall survival time was 12,93 months. The median duration of the response (CR+PR+SD) was 18,43 months (12,20–24,10 months), being higher than 12 months in 76,9% of the patients. Overall toxicity was generally mild. Metronomic chemotherapy combined with 1E10-Alum vaccine immunotherapy might be a useful therapeutic option for the treatment of metastatic breast cancer due to its potential impact on survival and patient quality of live, low toxicity and advantages of the administration.http://dx.doi.org/10.4061/2011/710292
spellingShingle Jorge L. Soriano
Noyde Batista
Eduardo Santiesteban
Mayté Lima
Joaquín González
Robin García
Yohanka Zarza
María V. López
Myriam Rodríguez
Jorge L. Loys
Narciso Montejo
Frank Aguirre
Amparo Macías
Ana M. Vázquez
Metronomic Cyclophosphamide and Methotrexate Chemotherapy Combined with 1E10 Anti-Idiotype Vaccine in Metastatic Breast Cancer
International Journal of Breast Cancer
title Metronomic Cyclophosphamide and Methotrexate Chemotherapy Combined with 1E10 Anti-Idiotype Vaccine in Metastatic Breast Cancer
title_full Metronomic Cyclophosphamide and Methotrexate Chemotherapy Combined with 1E10 Anti-Idiotype Vaccine in Metastatic Breast Cancer
title_fullStr Metronomic Cyclophosphamide and Methotrexate Chemotherapy Combined with 1E10 Anti-Idiotype Vaccine in Metastatic Breast Cancer
title_full_unstemmed Metronomic Cyclophosphamide and Methotrexate Chemotherapy Combined with 1E10 Anti-Idiotype Vaccine in Metastatic Breast Cancer
title_short Metronomic Cyclophosphamide and Methotrexate Chemotherapy Combined with 1E10 Anti-Idiotype Vaccine in Metastatic Breast Cancer
title_sort metronomic cyclophosphamide and methotrexate chemotherapy combined with 1e10 anti idiotype vaccine in metastatic breast cancer
url http://dx.doi.org/10.4061/2011/710292
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