Metronomic Oral Cyclophosphamide in Patients with Advanced Solid Tumors

Background: Cure is rarely achieved in patients with advanced metastatic solid tumors, and quality of life including times without burdening therapies is an important endpoint. Metronomic oral cyclophosphamide (Cy) has been studied before and is a reasonable option. Patients and Methods: 24 patients with a mean age of 64.4 years (range 36-82 years) were studied. 18 patients had breast cancer, 4 prostate cancer, 1 uterine carcinoma, and 1 carcinoma of unknown primary. Results: All patients had advanced disease with a mean of 2 metastatic sites. Cy was given at a mean dosage of 52 mg daily. Time from diagnosis to start of Cy was 108.6 +/- 7.6 months, and from occurrence of metastatic disease to Cy 45.8 +/- 45.6 months. Patients had received a mean of 4.2 +/- 2.1 prior regimens for metastatic disease. The mean time to treatment failure was 6.4 +/- 5.4 months, and mean overall survival was 12.7 +/- 7.3 months. Patients received 2.1 +/- 1.4 further treatments upon progression. Main toxicities were grade 1 and 2 (n = 25); 3 patients had grade 3 nausea, leucopenia, and elevated gamma glutamyl transferase, respectively. Conclusion: Low-dose oral Cy is a reasonable, generally well tolerated, and inexpensive option for patients with advanced solid tumors.