Yoshihiro Nishida1, Satoshi Tsukushi2, Hiroshi Urakawa2,3, Shunsuke Hamada2, Eiji Kozawa2, Kunihiro Ikuta2, Yuichi Ando3, Naoki Ishiguro2. 1. Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65-Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan. ynishida@med.nagoya-u.ac.jp. 2. Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65-Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan. 3. Department of Clinical Oncology and Chemotherapy, Nagoya University Graduate School and School of Medicine, 65-Tsurumai, Showa, Nagoya, 466-8550, Japan.
Abstract
BACKGROUND: This study was conducted to determine the efficacy and safety of low-dose chemotherapy with methotrexate (MTX) and vinblastine (VBL) for patients with desmoid tumors refractory to meloxicam treatment, focusing in particular on the relationship between the efficacy of this chemotherapy and catenin β-1 (CTNNB1) mutation status. PATIENTS AND METHODS: Since March 2003, patients pathologically diagnosed with extraperitoneal desmoid tumors have been prospectively treated with meloxicam, a COX-2 inhibitor, at our institution. Patients with inoperable tumors who were resistant to meloxicam treatment underwent MTX and VBL therapy every other week. The responses of all patients were evaluated, and factors that were correlated with efficacy were analyzed, including CTNNB1 mutation status. RESULTS: Sixty-eight patients were prospectively treated with meloxicam. MTX + VBL therapy was administered in 15 patients. Six patients showed a partial response. Only one patient presented disease progression. A few patients showed grade 3-4 treatment-related toxicity with the administration of MTX and VBL every other week. Intriguingly, CTNNB1 status did not affect the efficacy of this treatment. CONCLUSION: MTX and VBL treatment every other week is well tolerated and achieved a favorable response in patients resistant to meloxicam treatment, regardless of CTNNB1 mutation status.
BACKGROUND: This study was conducted to determine the efficacy and safety of low-dose chemotherapy with methotrexate (MTX) and vinblastine (VBL) for patients with desmoid tumors refractory to meloxicam treatment, focusing in particular on the relationship between the efficacy of this chemotherapy and catenin β-1 (CTNNB1) mutation status. PATIENTS AND METHODS: Since March 2003, patients pathologically diagnosed with extraperitoneal desmoid tumors have been prospectively treated with meloxicam, a COX-2 inhibitor, at our institution. Patients with inoperable tumors who were resistant to meloxicam treatment underwent MTX and VBL therapy every other week. The responses of all patients were evaluated, and factors that were correlated with efficacy were analyzed, including CTNNB1 mutation status. RESULTS: Sixty-eight patients were prospectively treated with meloxicam. MTX + VBL therapy was administered in 15 patients. Six patients showed a partial response. Only one patient presented disease progression. A few patients showed grade 3-4 treatment-related toxicity with the administration of MTX and VBL every other week. Intriguingly, CTNNB1 status did not affect the efficacy of this treatment. CONCLUSION:MTX and VBL treatment every other week is well tolerated and achieved a favorable response in patients resistant to meloxicam treatment, regardless of CTNNB1 mutation status.
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