title: Exploratory predictive and prognostic factors in advanced breast cancer treated with metronomic chemotherapy.
abstract: The aim of the present study is to evaluate the clinical and biological factors (including markers of angiogenesis) as potential predictors of prognosis and benefit from metronomic therapy in patients with advanced breast cancer (ABC). Recent data suggest antiangiogenic activity of metronomic therapy. The study population included 62 patients with pretreated ABC who received cyclophosphamide and methotrexate orally. Tumour samples were analysed by immunohistochemistry for HER2, Ki-67, thymidine phosphorylase (TP), vascular endothelial growth factor and vascular endothelial growth factor receptor. The results from immunohistochemical analysis and clinico-pathological variables were studied to test their potential association with benefit from metronomic therapy. The median overall survival, progression-free survival and survival postprogression were 7.1 (range 0.2-38.3), 2.6 (range 0.2-28.9) and 3 (range 0-34.2) months, respectively. Among the clinical variables, age, performance status and previous therapy with taxanes were significantly associated with outcomes. Among the molecular markers, TP was found to be associated with progression-free survival. Metronomic therapy is an effective choice for ABC. Young women with a more indolent disease had the greatest benefit from this treatment. TP tumour expression might aid decision making but these findings must be confirmed in larger prospective, properly designed studies.
authors: Department of Oncology, University of Udine, Udine, Italy.
authors: Manuela
authors: M
authors: Miscoria
authors: Fabrizio
authors: F
authors: Tonetto
authors: Laura
authors: L
authors: Deroma
authors: Piernicola
authors: P
authors: Machin
authors: Carla
authors: C
authors: Di Loreto
authors: Pamela
authors: P
authors: Driol
authors: Alessandro Marco
authors: AM
authors: Minisini
authors: Stefania
authors: S
authors: Russo
authors: Claudia
authors: C
authors: Andreetta
authors: Mauro
authors: M
authors: Mansutti
authors: Giuseppe
authors: G
authors: Damante
authors: Gianpiero
authors: G
authors: Fasola
authors: Fabio
authors: F
authors: Puglisi
mesh_terms: D059250:Administration, Metronomic; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage* / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008727:Methotrexate / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D040262:Receptors, Vascular Endothelial Growth Factor / Q000378:metabolism; D013939:Thymidine Phosphorylase / Q000378:metabolism; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
chemical_list: D003520:Cyclophosphamide; D019394:Ki-67 Antigen; D008727:Methotrexate; D018719:Erb-b2 Receptor Tyrosine Kinases; D040262:Receptors, Vascular Endothelial Growth Factor; D013939:Thymidine Phosphorylase; D042461:Vascular Endothelial Growth Factor A; C467484:VEGFA protein, human; C508053:ERBB2 protein, human