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Review

Cyclic Metronomic Chemotherapy for Pediatric Tumors: Six Case Reports and a Review of the Literature

by 1,2,* and 3,*
1
Department of Pediatric Hematology Oncology, El Paso Children’s Hospital, El Paso, TX 79905, USA
2
Department of Pediatrics, Texas Tech University Health Science Center, El Paso, TX 79430, USA
3
Border Biomedical Research Center, University of Texas at El Paso (UTEP), El Paso, TX 79968, USA
*
Authors to whom correspondence should be addressed.
Academic Editors: Johannes Van Den Anker and Nikolas Herold
J. Clin. Med. 2022, 11(10), 2849; https://doi.org/10.3390/jcm11102849
Received: 14 March 2022 / Revised: 6 April 2022 / Accepted: 13 May 2022 / Published: 18 May 2022
(This article belongs to the Special Issue Clinical Applications of Metronomic Chemotherapy)
We report a retrospective case series of six Hispanic children with tumors treated with metronomic chemotherapy. The six cases comprised one rhabdoid tumor of the kidney, one ependymoma, two medulloblastomas, one neuroblastoma, and a type II neurocytoma of the spine. Treatment included oral cyclophosphamide daily for 21 days alternating with oral etoposide daily for 21 days in a backbone of daily valproic acid and celecoxib. In one case, celecoxib was substituted with sulindac. Of the six patients, three showed complete responses, and all patients showed some response to metronomic therapy with only minor hematologic toxicity. One patient had hemorrhagic gastritis likely associated with NSAIDs while off prophylactic antacids. These data add to a growing body of evidence suggesting that continuous doses of valproic acid and celecoxib coupled with alternating metronomic chemotherapy of agents such as etoposide and cyclophosphamide can produce responses in pediatric tumors relapsing to conventional dose chemotherapy. View Full-Text
Keywords: metronomic chemotherapy; pediatric tumors; cyclophosphamide; etoposide; valproic acid metronomic chemotherapy; pediatric tumors; cyclophosphamide; etoposide; valproic acid
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MDPI and ACS Style

Carcamo, B.; Francia, G. Cyclic Metronomic Chemotherapy for Pediatric Tumors: Six Case Reports and a Review of the Literature. J. Clin. Med. 2022, 11, 2849. https://doi.org/10.3390/jcm11102849

AMA Style

Carcamo B, Francia G. Cyclic Metronomic Chemotherapy for Pediatric Tumors: Six Case Reports and a Review of the Literature. Journal of Clinical Medicine. 2022; 11(10):2849. https://doi.org/10.3390/jcm11102849

Chicago/Turabian Style

Carcamo, Benjamin, and Giulio Francia. 2022. "Cyclic Metronomic Chemotherapy for Pediatric Tumors: Six Case Reports and a Review of the Literature" Journal of Clinical Medicine 11, no. 10: 2849. https://doi.org/10.3390/jcm11102849

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