{"title":"Mytomicin-C、节拍卡培他滨和贝伐单抗在阑尾源性腹膜假性粘液瘤不可切除或复发患者中的应用。","authors":"Filippo Ghelardi , Alessandra Raimondi , Federica Morano , Giovanni Randon , Alessandra Pannone , Marcello Guaglio , Giacomo Mazzoli , Vincenzo Nasca , Massimo Milione , Giuseppe Leoncini , Giovanna Sabella , Gabriella Francesca Greco , Bianca Rosa Lampis , Margherita Galassi , Sara Delfanti , Margherita Nannini , Rossana Intini , Dario Baratti , Maria Di Bartolomeo , Marcello Deraco , Filippo Pietrantonio","doi":"10.1016/j.clcc.2023.08.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p><span>Pseudomyxoma peritonei<span> (PMP) is a rare, slow growing tumor, traditionally considered chemoresistant. The only curative approach is cytoreductive surgery<span> (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC). At disease relapse, or </span></span></span>in patients<span> with inoperable disease at diagnosis, no standard treatment has been defined, though nonrandomized series showed promising results with fluoropyrimidine-based regimens.</span></p></div><div><h3>Patients and Methods</h3><p><span><span>We conducted a prospective study in patients with relapsed or unresectable PMP and confirmed disease progression at baseline. Patients received </span>MMC (7 mg/m</span><sup>2</sup><span> every 6 weeks, up to a maximum of 4 cycles) plus metronomic capecitabine<span> (625 mg/sqm/day b.i.d.) and bevacizumab (7.5 mg/kg every 3 weeks) until disease progression, unacceptable toxicity, or consent withdrawal. Primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), overall response rate according to RECIST v1.1 criteria, serum markers response and safety.</span></span></p></div><div><h3>Results</h3><p>Fifteen patients were included. At a median follow-up of 26.1 months (IQR, 17.7-49.6), median PFS was 17.9 months (95% CI, 11.0-NE), with 1-year PFS and OS rates of 73% and 87%. Safety profile was manageable, with only 13% G3/G4 treatment-related adverse events.</p></div><div><h3>Conclusion</h3><p>Metronomic capecitabine, bevacizumab, and MMC are an active regimen in advanced and progressive PMP and favorably compares with historical series.</p></div>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mytomicin-C, Metronomic Capecitabine, and Bevacizumab in Patients With Unresectable or Relapsed Pseudomyxoma Peritonei of Appendiceal Origin\",\"authors\":\"Filippo Ghelardi , Alessandra Raimondi , Federica Morano , Giovanni Randon , Alessandra Pannone , Marcello Guaglio , Giacomo Mazzoli , Vincenzo Nasca , Massimo Milione , Giuseppe Leoncini , Giovanna Sabella , Gabriella Francesca Greco , Bianca Rosa Lampis , Margherita Galassi , Sara Delfanti , Margherita Nannini , Rossana Intini , Dario Baratti , Maria Di Bartolomeo , Marcello Deraco , Filippo Pietrantonio\",\"doi\":\"10.1016/j.clcc.2023.08.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p><span>Pseudomyxoma peritonei<span> (PMP) is a rare, slow growing tumor, traditionally considered chemoresistant. The only curative approach is cytoreductive surgery<span> (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC). At disease relapse, or </span></span></span>in patients<span> with inoperable disease at diagnosis, no standard treatment has been defined, though nonrandomized series showed promising results with fluoropyrimidine-based regimens.</span></p></div><div><h3>Patients and Methods</h3><p><span><span>We conducted a prospective study in patients with relapsed or unresectable PMP and confirmed disease progression at baseline. Patients received </span>MMC (7 mg/m</span><sup>2</sup><span> every 6 weeks, up to a maximum of 4 cycles) plus metronomic capecitabine<span> (625 mg/sqm/day b.i.d.) and bevacizumab (7.5 mg/kg every 3 weeks) until disease progression, unacceptable toxicity, or consent withdrawal. Primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), overall response rate according to RECIST v1.1 criteria, serum markers response and safety.</span></span></p></div><div><h3>Results</h3><p>Fifteen patients were included. At a median follow-up of 26.1 months (IQR, 17.7-49.6), median PFS was 17.9 months (95% CI, 11.0-NE), with 1-year PFS and OS rates of 73% and 87%. Safety profile was manageable, with only 13% G3/G4 treatment-related adverse events.</p></div><div><h3>Conclusion</h3><p>Metronomic capecitabine, bevacizumab, and MMC are an active regimen in advanced and progressive PMP and favorably compares with historical series.</p></div>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1533002823000786\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1533002823000786","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
Mytomicin-C, Metronomic Capecitabine, and Bevacizumab in Patients With Unresectable or Relapsed Pseudomyxoma Peritonei of Appendiceal Origin
Introduction
Pseudomyxoma peritonei (PMP) is a rare, slow growing tumor, traditionally considered chemoresistant. The only curative approach is cytoreductive surgery (CRS) followed by hyperthermic intraperitoneal chemotherapy (HIPEC). At disease relapse, or in patients with inoperable disease at diagnosis, no standard treatment has been defined, though nonrandomized series showed promising results with fluoropyrimidine-based regimens.
Patients and Methods
We conducted a prospective study in patients with relapsed or unresectable PMP and confirmed disease progression at baseline. Patients received MMC (7 mg/m2 every 6 weeks, up to a maximum of 4 cycles) plus metronomic capecitabine (625 mg/sqm/day b.i.d.) and bevacizumab (7.5 mg/kg every 3 weeks) until disease progression, unacceptable toxicity, or consent withdrawal. Primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), overall response rate according to RECIST v1.1 criteria, serum markers response and safety.
Results
Fifteen patients were included. At a median follow-up of 26.1 months (IQR, 17.7-49.6), median PFS was 17.9 months (95% CI, 11.0-NE), with 1-year PFS and OS rates of 73% and 87%. Safety profile was manageable, with only 13% G3/G4 treatment-related adverse events.
Conclusion
Metronomic capecitabine, bevacizumab, and MMC are an active regimen in advanced and progressive PMP and favorably compares with historical series.
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