Metronomics Global Health Initiative

the e-cancer/MGHI "metronomic" interviews series

2014-08-15T14:59:00Z

The Ecancer website has released the videos of the "ecancer/MGHI metronomic interviews series" that have been shoot during the 4th metronomic meeting that took place in Mliano last June.
The following interviews are available :

– Dr Nicolas André from the Hôpital pour Enfants de La Timone and MGHI, Marseille, France talks about the use of metronomic chemotherapy in frail and unfit patients, as well as its benefits as an orally administered treatment and one that is cost-effective for low income countries. In particular, he discusses the aims and work of the Metronomic Global Health Initiative. In addition, he notes the strides being made in drug repurposing.

– Pr Guido Bocci from University of Pisa, Pisa, Italy talks t about the benefits of metronomic treatment and alos highlights the difficulties faced in trying to find biomarkers or funding.

– Dr Alexandru Eniu from the Cancer Institute Ion Chiricuta Cluj-Napoca, Cluj-Napoca, Romania talks about the treatment of cancer in low and middle income countries with a particular focus on breast cancer.

– Pr Yuval Shaked from the Israel Institute of Technology, Haifa, Israel talks about the benefits of a metronomic chemotherapy regimen as a less aggressive treatment than high dose chemotherapy and a more effective maintenance drug, preventing relapse and decreasing metastic burden and highlights the differences in host response following metronomic chemotherapy.

– Dr Lisa Hutchinson, - Editor of Nature Reviews, London, UK talks about the benefits of metronomic chemotherapy and drug repurposing, whilst noting the challenges facing it such as a lack of rigorous definitions and terminology, limited knowledge about dosage efficacy, and difficulties surrounding funding. She also talk about talks about the work of her journal, Nature Review Clinical Oncology.

– Pr Shripad Banavali from the Tata Memorial Hospital, Mumbai, India talks about drug repurposing to overcome economic difficulties in global cancer care

Three interviews then deals with neuroblastoma.

– Pr Jaroslav Sterba from the University Children's Hospital Brno, Brno, Czech Republic talks about the benefits of metronomic therapy in treating neuroblastoma. He also discusses metronomics can be combined with other treatment strategies such as immunotherapy.

– Pr Frank Berthold from University Hospital Köln, Köln, Germany talks about the use of metronomic therapy in treating children with neuroblastoma.

– Dr Eddy Pasquier from the Children's Cancer Institute Australia, Randwick, Australia talks about drug repurposing with emphasis on the use of betablockers, previously used as antihypertensive drugs, in combination with chemotherapy to treat neuroblastoma.

– Dr Gauthier Bouche from Anticancer Fund, Strombeek-Bever, Belgium talks about repurposing generics molecules to fight cancer and the work of the REDO project.

– Lastly, Pr Francesco Bertolini from the European Institute of Oncology, Milan, Italy talks about metronomic therapy and drug repurposing and highlight the potential use of metformin, formerly used in diabetes, to treat breast cancer,.

The videos can aslo be found[here] on the ecancer website or on youtube.

Ecancer-MGHI "metronomic" interview series

2014-05-22T10:21:25Z

MGHI and Ecancer have agreed to work together to make a series of interviews of the most influent clinicians and researchers involved in the field of metronomics who will gather for the 4th Metronomic Meeting in Milano next June.

Ecancer is the leading oncology channel committed to improving cancer communication and education with the goal of optimising patient care and outcomes. By using the latest technologies Ecancer works closely with leading figures in oncology to inform and educate the global cancer community.

Together with Lara Finan Senior Publisher and Dr Linda Cairns Science Editor from ecancermedicalscience; we aim at providing views of experts about a broad range of topics related to metronomics to foresee the future of metronomics in adults and in children living either in rich or low/middle income countries. We also wish to hilight key issues such as :
– how does metronomics work ?
– what is research on metronmics aiming at ?
– in which diseases have the best results been obtained so far?
– at what stage of treatment is it best to give metronomics ?
– can metronomic be combined with modern therapies such as immunotherapy and TKI?
– what is drug repositioning ?
....

The interviews will be posted both on the Ecancer website and on the MGHI website, shortly after the meeting.

MGHI and the Cannes-Nice Marathon

2013-10-05T17:04:00Z

Why MGHI would be running a marathon ?

Well can you think of anything more metronomic than running regularly, step after step, seconds after seconds, minutes after minutes, hours after hours for 42.2 km (26.2 miles) ?

So, to be fully metronomic and why not raise a little money, we have set a MGHI team to go running the [Nice-Cannes marathon] along the French Riviera coast on the 10th of November.

9 committed runners trained hard : 3 for the first full marathon of their life (Séverine LeMenestrel, Julie Szczot and Nicolas André) and 6 runners (Laetitia Padovani, Xavier Murraciole, Marianne Vilpini, Céline Ratineau, Marc Gereys and Julien Charier) relayed for 3 others marathons.
2 of of runners could not make it on D-day for logistic reasons but otherwise all runners achieved their goal and completed 5 marathons, more than 200km proudly wearing our brand new MGHI T-shirts.

I you want to support us click here (in french) or here (in english) that willtake you on the official institutional pediatric oncology healthcare network (RESOP). The money raised will be dedicated to paediatric metronomic projects in low and middle income countries.

The "Metronomic" special issue of the Indian Journal of Cancer is out !

2013-09-09T16:47:16Z

We are very glad to announce that the "Metronomic special issue" initiated by the Indian Journal of Cancer has been released. You may find below the titles of the articles (reviews, case reports, series) contained in this issue. All articles can be freely assessed on the website of the journal here.
This is the very first metronomic special ever published, and we are very happy it is about metronomic in LMIC, further highlighting the growing interest in this approach. We are also very proud to have been commissioned to write an accompanying editorial.

– Metronomics in low and middle income countries: India showing the way!
N André, E Pasquier

– Association between baseline VEGF/sVEGFR-2 and VEGF/TSP-1 ratios and response to metronomic chemotherapy using cyclophosphamide and celecoxib in patients with advanced breast cancer
HA Perroud, MJ Rico, CM Alasino, SM Pezzotto, VR Rozados, OG Scharovsky

– Efficacy and safety of metronomic administration of paclitaxel for advanced recurrent non-small-cell lung cancer
V Noronha, VM Patil, A Joshi, K Prabhash

– Metronomic weekly paclitaxel in advanced unresectable esophageal cancer
V Noronha, V Patil, B Bhosale, A Joshi, N Purandare, K Prabhash

– Oral metronomic scheduling of anticancer therapy-based treatment compared to existing standard of care in locally advanced oral squamous cell cancers: A matched-pair analysis
PS Pai, AD Vaidya, K Prabhash, SD Banavali

– Metronomic therapy: Chemotherapy revisited
V Noronha, MV Krishna, V Patil, A Joshi, SD Banavali, K Prabhash

– Can combination metronomic therapy overcome chemoresistance in cholangiocarcinoma? A literature review
SD Banavali, NR Patil, VS Nirabhawane, BB Bhosale, SB Desai

– Is there a role for metronomic induction (and maintenance) therapy in elderly patients with acute myeloid leukemia? A literature review
N Tandon, S Banavali, H Menon, S Gujral, PA Kadam, A Bakshi

Pilot study of a pediatric metronomic 4-drug regimen

2011-12-06T11:58:11Z

Pilot study of a pediatric metronomic 4-drug regimen

Nicolas André, Sylvie Abed, Daniel Orbach, Corinne Armari Alla, Laetitia Padovani, Eddy Pasquier, Jean Claude Gentet, Arnauld Verschuur

Oncotarget 2012; 2: 960 - 965

free full text available here=30]

Background: Metronomic chemotherapy (MC) is defined as the frequent administration of chemotherapy at doses below the maximal tolerated dose and with no prolonged drug-free break. MC is gaining interest as an alternative strategy to fight resistant cancer.
Objective: to assess the safety of 4 drug MC regimen in paediatric patients with refractory or relapsing various tumour types.
Setting: From November 2008 to December 2010, in three academic paediatric oncology centers, 16 children (median age 12 years old; range 5.5-20) were included in this pilot study. This treatment was proposed to children with refractory disease for whom no further effective treatments were available. Most frequent diagnosis were medulloblastoma/cerebral PNET (5) osteosarcoma (5), and one case each of nephroblastoma, high grade glioma, Hodgkin lymphoma, rhabdomyosarcoma, neuroblastoma and kidney rhabdoid tumour. The MC regimen consisted in cycles of 56 days (8 weeks) with weekly vinblastine 3 mg/m2 (week 1-7), daily cyclophosphamide 30 mg/m2 (days 1-21), and twice weekly methotrexate 10 mg/m² (days 21-42), and daily celecoxib 200 mg to 400 mg twice daily (days1-56) followed by a 2-weeks chemotherapy break. Adverse events were determined through laboratory analysis and investigator observations.
Results: One objective response was observed in a patient with Hodgkin lymphoma, and 4 patients experienced disease stabilization and continued their treatment for 3 cycles (24 weeks) or more. At last follow-up, 7 patients (43%) are alive including 1 still undergoing treatment. During the overall 36 cycles of treatments received by patients, 4 grade IV toxicities and 24 grade III toxicities were observed in11 cycles in only 10 different patients.
Conclusion: The metronomic regimen we report here was well tolerated and associated with disease stabilization. This regimen is currently being evaluated in a national multicenter phase II study.

Metro-Mali 01

Nicolas André — 2011-06-03T14:24:07Z

Children treated with metronomic chemotherapy in a low-income country: METROMALI-01.
Fousseyni T, Diawara M, Pasquier E, André N.
J Pediatr Hematol Oncol. 2011 Jan;33(1):31-4.

Abstract
BACKGROUND:
Metronomic chemotherapy (MC) is defined as the frequent administration of chemotherapy at doses below the maximal tolerated dose and with no prolonged drug-free break. As off-patent chemotherapeutic drugs can be used and given the low toxicity profile of this approach, MC seems to be well adapted to low-income countries.

OBJECTIVE:
The aim of this study was to assess the efficacy and safety of a vincristine/cyclophosphamide/methotrexate MC regimen given to children with refractory cancer of various tumor types.

METHODS:
This prospective, pilot, single-center study evaluated the use of MC with a first cycle consisting of weekly vincristine (1.5 mg/m) on days 1, 8, 15, and 22, daily cyclophosphamide (25 mg/m) on days 1 to 21, and twice weekly methotrexate (15 mg/m) on days 21 to 42, followed by a 1-week break. For the following cycles, vincristine was administered only at weeks 1 and 5 of the cycle. This treatment was proposed to children with refractory cancer following treatments with the standard protocols available in our institution and to patients who were not eligible for the protocol. Adverse events were determined through laboratory analyses and investigator observations.

RESULTS:
From November 2008 to December 2009, 12 children (median age, 3.7 y; range, 2 to 7 y) were included. The most frequent diagnoses were Wilms tumors (6) and retinoblastoma (5). No objective response was observed, but 7 patients experienced disease stabilization (58%) and continued their treatment for 15 to 24 weeks. After a median follow-up of 39 weeks, 6 patients (50%) were alive. Most importantly, in 3 patients (25%), disease remained stable for at least 6 months after completion of treatment. One grade 4 anemia was observed in 1 patient and 1 grade 4 nonfebrile neutropenia in 1 patient. No other grade 3 or 4 toxicities were noted.

CONCLUSION:
The MC regimen that we report here was well tolerated and was associated with disease stabilization. Most importantly, stabilization could be maintained for over 6 additional months after completion of treatment in 3 patients. The potential of MC in children and young adults in low-income countries warrants further studies.

Metronomics Global Health Initiative

the e-cancer/MGHI "metronomic" interviews series

Ecancer-MGHI "metronomic" interview series

MGHI and the Cannes-Nice Marathon

Why MGHI would be running a marathon ?

The "Metronomic" special issue of the Indian Journal of Cancer is out !

Table of Contents

Pilot study of a pediatric metronomic 4-drug regimen

Metro-Mali 01