Metronomic cyclophosphamide‑induced long‑term remission after recurrent high‑grade serous ovarian cancer: A case study

de Boo,Leonora   Wijnandina; Vulink,Annelie  Johanna Elisabeth; Bos,Monique   Elisabeth Martina Maria

doi:10.3892/mco.2017.1457

Metronomic cyclophosphamide‑induced long‑term remission after recurrent high‑grade serous ovarian cancer: A case study

Authors:
- Leonora Wijnandina de Boo
- Annelie Johanna Elisabeth Vulink
- Monique Elisabeth Martina Maria Bos
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Affiliations: Department of Internal Medicine, Reinier de Graaf Hospital, 2625AD Delft, The Netherlands, Division of Medical Oncology, Reinier de Graaf Hospital, 2625AD Delft, The Netherlands, Department of Medical Oncology, Erasmus Medical Center, 3015 CE Rotterdam, The Netherlands
Published online on: October 18, 2017 https://doi.org/10.3892/mco.2017.1457
Pages: 1130-1134

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Abstract

Metronomic oral cyclophosphamide has gained increasing interest in recent years as a promising maintenance therapy in advanced, platinum-sensitive, high-grade serous ovarian cancer (HGSOC). Metronomic treatment with cyclophosphamide refers to the frequent, usually daily, administration of a low (oral) dose of cyclophosphamide with no prolonged drug-free breaks. Main advantages of this treatment are the effective reduction of tumour activity, oral administration in an outpatient setting, low cost and the low toxicity profile. Metronomic oral cyclophosphamide can benefit patients suffering from types of cancer known to be sensitive to alkylating agents, such as platinum-sensitive HGSOC. In recent years, several publications have underlined the advantage of this regimen and possible explanations were explored. We here present a patient with multiple recurrences of metastasized HGSOC, platinum-sensitive, with an on-going complete response to monotherapy with oral cyclophosphamide. This observation supports that patients with relapsing HGSOC who responded to platinum-based chemotherapy and cannot continue platinum-based chemotherapy because of toxicity, can be offered a course of metronomic cyclophosphamide. This case may serve as a reminder that old drugs can be used successfully even in the age of new upcoming therapy such as anti-angiogenic agents (VEGF inhibitors) and poly-ADP-ribose polymerase (PARP) inhibitors.

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