TITLE:
Efficacy Study of Metronomic Chemotherapy in Metastatic Triple Negative Breast Cancer and Correlation with VEGF, TSP Levels
AUTHORS:
B. J. Srinivasa, Lalkota Prakash Bhanu, Vidhya H. Veldore, R. Raghavendra, Radheshyam Naik
KEYWORDS:
Metronomic Chemotherapy, MBC, Cyclophosphamide, Methotrexate
JOURNAL NAME:
Advances in Breast Cancer Research,
Vol.7 No.2,
April
13,
2018
ABSTRACT: Background: Treatment refractory metastatic breast cancer patients are at best
treated palliatively. We evaluated the effects of metronomic chemotherapy on
survival outcomes in this population. Methods: Twenty eight subjects
with treatment refractory (n = 21) and
treatment naive (n = 7) MBC were included in an open label single arm efficacy study of
metronomic chemotherapy. Patients were given a chemotherapy regimen of Tab.
Cyclophosphamide 50 mg once daily and Tab. Methotrexate 2.5 mg
twice in a week over a minimum period of 3 months or until the progression of
their disease whichever was earlier. Monitoring of serum VEGF and
Thrombospondin levels were done to correlate the response rates. Data were
analysed using chi square test for proportions and Kaplan Meir Survival
analysis. Results: The mean age of the study population was 51.5 ± 14.2
years. The mean duration of metronomic chemotherapy was 123.89 ± 97.6
days. Overall 71.4% had progressive disease and 28.6% had stable disease. 55.6%
with treatment naive metastatic breast cancer had stable disease compared to
15.8% of treatment refractory metastatic breast cancer. There was also a
significant improvement in progression free survival in those with tumor load
less than 5 cms compared to >5 cms and
in grade 2 compared to grade 3 disease. There was no correlation of serum VEGF
levels before and after chemotherapy. There is no significant decrease in TSP
levels. Conclusion: The results suggest stable response in one third of
study patients. Performance status and tumor load are important predictors in
this category of population. There is no significant correlation of serum VEGF
and TSP levels before and after chemotherapy. Also, there was no significant correlation of biomarker levels in
responding and non-responding patients.