Low Dose "Metronomic" Chemotherapy Plus Cox 2 Inhibitor

CONCLUSIONS

•combination of ultra low dose chemotherapy using drugs such as vinblastine or taxol,(e.g.1/10 -1/20 the MTD)and anti- VEGF receptor2 antibodies (DC101)were effective in causing sustained regressions or inducing dormancy of large established human tumor xenografts S including prostate cancer.

•no significant toxicity was observed,despite continuous therapy for 3S7 months using this type of combination treatment

•in contrast,treatment with low dose chemotherapy alone,or DC101 alone,was only transiently effective,i.e.,relapses occurred,or was ineffective

•preliminary experiments suggest using a selective COX-2 inhibitor (Celebrex)as the anti-angiogenic drug may also be effective for this type of treatment strategy,thus making it possible to consider evaluating the concept in clinical trials

•phase II clinical trials in Toronto,and elsewhere in Ontario have been,or are about to be initiated,using continuous low dose chemotherapy (e.g.daily,50 mg,cyclophosphamide)and Celebrex,in a variety of advanced drug resistant malignancies, including relapsing,androgen independent prostate cancer

•for several reasons androgen independent prostate cancer would appear an ideal type of cancer to consider treating using the low dose metronomic combination anti-angiogenic chemotherapy strategy,not the least of which is the fact that elderly patients would be better able to cope with this type of therapy than protocols utilizing standard doses of cytotoxic drugs.

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