Metronomic Chemotherapy for Children in Low- and Middle-Income Countries: Survey of Current Practices and Opinions of Pediatric Oncologists - CNRS - Centre national de la recherche scientifique Accéder directement au contenu
Article Dans Une Revue Journal of Global Oncology Année : 2019

Metronomic Chemotherapy for Children in Low- and Middle-Income Countries: Survey of Current Practices and Opinions of Pediatric Oncologists

Gabriel Revon-Rivière
  • Fonction : Auteur
Laila Heississen
  • Fonction : Auteur
Wendy Gomez Garcia
  • Fonction : Auteur
Babak Abdolkarimi
  • Fonction : Auteur
Manickavallie Vaithilingum
  • Fonction : Auteur
Chi-Kong Li
  • Fonction : Auteur
Ping Chung Leung
  • Fonction : Auteur
Prabhat Malik
  • Fonction : Auteur
Sidnei Epelman
  • Fonction : Auteur
Guillermo Chantada

Résumé

PURPOSE Low-and middle-income countries (LMICs) experience the burden of 80% of new childhood cancer cases worldwide, with cure rates as low as 10% in some countries. Metronomics combines frequent administrations of low-dose chemotherapy with drug repurposing, which consists of using already-approved drugs for new medical applications. With wide availability, limited costs, and little infrastructure needs, metronomics can be part of constraint-adapted regimens in these resource-limited settings-with the understanding that metronomics shall not be a substitute for standard treatments when available and doable. Our study aims to describe the experience, practices, opinions, and needs in metronomics of physicians working in LMICs. METHODS An online questionnaire was sent to more than 1,200 physicians in pediatric oncology networks in LMICs. Items included the type of center, physician's demographics, experience in pediatric oncology, and experience with current knowledge of metronomics. Opinions and perspectives were explored using multiple-answer and open questions. RESULTS Of physicians, 17% responded. Of respondents, 54.9% declared that they had already used a metronomic regimen. The most frequently cited repositioned drugs were celecoxib (44%) followed by propranolol and valproic acid (17%). Respondents highlighted the advantages of outpatient use (20%) and expected low toxicity (24%). In considering the drawbacks of metronomics, 47% of responses highlighted the lack of scientific evidence or guidelines, 33% the availability or affordability of drugs, and 18% the problem of acceptance or compliance. Of physicians, 79% believed that use of metronomics will spread in LMICs in the near future and 98% of them were willing to participate in international metronomic protocols or registries. CONCLUSION Metronomics is already used in LMICs and is a potential answer to unmet needs in pediatric oncology. There is room for improvement in the availability of drugs and a necessity to develop collaborative protocols and research to generate level A evidence
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hal-02366469 , version 1 (20-04-2020)

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Gabriel Revon-Rivière, Shripad Banavali, Laila Heississen, Wendy Gomez Garcia, Babak Abdolkarimi, et al.. Metronomic Chemotherapy for Children in Low- and Middle-Income Countries: Survey of Current Practices and Opinions of Pediatric Oncologists. Journal of Global Oncology, 2019, 5, pp.1-8. ⟨10.1200/JGO.18.00244⟩. ⟨hal-02366469⟩

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