Low-dose chemotherapy with methotrexate and vinblastine for patients with desmoid tumors: relationship to CTNNB1 mutation status

Int J Clin Oncol. 2015 Dec;20(6):1211-7. doi: 10.1007/s10147-015-0829-0. Epub 2015 Apr 22.

Abstract

Background: This study was conducted to determine the efficacy and safety of low-dose chemotherapy with methotrexate (MTX) and vinblastine (VBL) for patients with desmoid tumors refractory to meloxicam treatment, focusing in particular on the relationship between the efficacy of this chemotherapy and catenin β-1 (CTNNB1) mutation status.

Patients and methods: Since March 2003, patients pathologically diagnosed with extraperitoneal desmoid tumors have been prospectively treated with meloxicam, a COX-2 inhibitor, at our institution. Patients with inoperable tumors who were resistant to meloxicam treatment underwent MTX and VBL therapy every other week. The responses of all patients were evaluated, and factors that were correlated with efficacy were analyzed, including CTNNB1 mutation status.

Results: Sixty-eight patients were prospectively treated with meloxicam. MTX + VBL therapy was administered in 15 patients. Six patients showed a partial response. Only one patient presented disease progression. A few patients showed grade 3-4 treatment-related toxicity with the administration of MTX and VBL every other week. Intriguingly, CTNNB1 status did not affect the efficacy of this treatment.

Conclusion: MTX and VBL treatment every other week is well tolerated and achieved a favorable response in patients resistant to meloxicam treatment, regardless of CTNNB1 mutation status.

Keywords: CTNNB1; Desmoid tumor; Methotrexate; Vinblastine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Child
  • Cyclooxygenase 2 Inhibitors / therapeutic use
  • Drug Administration Schedule
  • Drug Resistance, Neoplasm
  • Female
  • Fibromatosis, Abdominal / drug therapy*
  • Fibromatosis, Abdominal / genetics*
  • Humans
  • Male
  • Meloxicam
  • Methotrexate / administration & dosage
  • Middle Aged
  • Mutation
  • Retreatment
  • Thiazines / therapeutic use
  • Thiazoles / therapeutic use
  • Vinblastine / administration & dosage
  • Young Adult
  • beta Catenin / genetics*

Substances

  • CTNNB1 protein, human
  • Cyclooxygenase 2 Inhibitors
  • Thiazines
  • Thiazoles
  • beta Catenin
  • Vinblastine
  • Meloxicam
  • Methotrexate