Anti‐inflammatory and angiostatic therapy in chemorefractory multisystem Langerhans’ cell histiocytosis of adults

Reichle, Albrecht; Vogt, Th.; Kunz-Schughart, Leoni A.; Bretschneider, T.; Bachthaler, Maike; Bross, K. J.; Freund, S.; Andreesen, Reinhard

doi:10.1111/j.1365-2141.2004.05359.x

Cited by 36 publications

(23 citation statements)

References 8 publications

(7 reference statements)

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“…Case report (pretreated patient, advanced disease) [400] Kaposi sarcoma Pioglitazone, Rofecoxib, Trofosfamide (metronomic)…”

Section: Combined Tumor-stroma-targeted Therapymentioning

confidence: 99%

New Indications for Established Drugs: Combined Tumor-Stroma-Targeted Cancer Therapy with PPARγ Agonists, COX-2 Inhibitors, mTOR Antagonists and Metronomic Chemotherapy

Hafner¹,

Reichle²,

Vogt

2005

CCDT

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In search of new strategies for the treatment of cancer, the interaction between tumor and stroma attracts more and more attention. Disruption of stroma functions, e.g. angiogenesis, has evolved into a promising target for cancer therapies. Since stromal cells are genetically stable, stroma-targeted therapies seem to be less susceptible to the development of drug resistance. Several well-established drugs, which had initially been developed for other indications, also exhibit antitumor activity. Among those, PPARgamma agonists, COX-2 inhibitors, and mTOR antagonists are the most remarkable examples. Current research data and clinical experience suggest that these drugs target stroma functions in cancer, in particular angiogenesis, but immunological mechanisms and direct antitumor effects seem to participate as well. In addition to these drugs, frequent administration of low-dose chemotherapeutics, referred to as metronomic chemotherapy, reveals profound anti-angiogenic effects. In the meantime, a multitude of preclinical and clinical studies have been undertaken, which demonstrate the efficacy of these drugs in cancer therapy. Combinatorial use of these agents has been suggested to be superior in terms of antitumor efficacy and prevention of drug resistance. The toxicity of these therapies is surprisingly low compared with conventional high-dose chemotherapy regimens. Patients with advanced disease, often heavily pretreated and presenting multiple drug resistance, could particularly profit from such tumor-stroma-targeted therapies. However, larger randomized clinical trials are required for further evaluation and optimization of this concept.

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“…Case report (pretreated patient, advanced disease) [400] Kaposi sarcoma Pioglitazone, Rofecoxib, Trofosfamide (metronomic)…”

Section: Combined Tumor-stroma-targeted Therapymentioning

confidence: 99%

New Indications for Established Drugs: Combined Tumor-Stroma-Targeted Cancer Therapy with PPARγ Agonists, COX-2 Inhibitors, mTOR Antagonists and Metronomic Chemotherapy

Hafner¹,

Reichle²,

Vogt

2005

CCDT

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“…The activity of Langerhans cells is regulated by the PPAR-γ. These findings lead to a new therapeutic scheme with pioglitazone (PPAR-γ agonist), etoricoxib (COX-2 inhibitor), and trofosfamide (alkylating medium),8, 9 which was applied in our patient. He tolerated the therapy without any side effects.…”

Section: Discussionmentioning

confidence: 88%

Multisystemic Langerhans cell histiocytosis in an adult

Hegemann

Schreml

2017

JAAD Case Reports

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“…However, the contribution of COX inhibitors cannot be discounted. Recent case reports show encouraging results using the tumor necrosis factor-a antagonist etanercept, 20,21 the PPAR-g antagonist pioglitazone, 15 2-Cda 22 and the COX-2 antagonist rofecoxib 15 to treat single-system disease. While these newer therapies show promise, we suggest that there is also an important role for the use of COX inhibitors as first-line monotherapy for LCH of bone.…”

Section: Discussionmentioning

confidence: 95%

“…Additionally, Reichle et al successfully used rofecoxib, a COX-2 antagonist, in the treatment of chemorefractory LCH. 15 On the basis of the aforementioned studies, it can be posited that prostaglandin inhibitors may prove to be an effective treatment for favorable site LCH. We here present 2 pediatric cases in which the use of the prostaglandin inhibitor naproxen, as monotherapy for osteolytic LCH, was associated with sustained favorable outcomes.…”

Section: Introductionmentioning

confidence: 99%

Prostaglandin Inhibitors in the Treatment of Single-system Langerhans Cell Histiocytosis: Pharmacologic Rationale and Report of Two Cases

Goldberg

O’Connor

Sprinz

2008

Journal of Pediatric Hematology/Oncology

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Therapeutic trials have confirmed the efficacy of a number of approaches to the treatment of single-system Langerhans cell histiocytosis (LCH). Not so well studied, but with some pharmacologic rationale and anecdotal reports of clinical success, are prostaglandin inhibitors. We present here a review of the possible mechanism of action of prostaglandin inhibitors in LCH and 2 cases of single-organ, single-site LCH treated with only prostaglandin inhibitors, both with sustained favorable clinical outcomes.

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Anti‐inflammatory and angiostatic therapy in chemorefractory multisystem Langerhans’ cell histiocytosis of adults

Cited by 36 publications

References 8 publications

New Indications for Established Drugs: Combined Tumor-Stroma-Targeted Cancer Therapy with PPARγ Agonists, COX-2 Inhibitors, mTOR Antagonists and Metronomic Chemotherapy

New Indications for Established Drugs: Combined Tumor-Stroma-Targeted Cancer Therapy with PPARγ Agonists, COX-2 Inhibitors, mTOR Antagonists and Metronomic Chemotherapy

Multisystemic Langerhans cell histiocytosis in an adult

Prostaglandin Inhibitors in the Treatment of Single-system Langerhans Cell Histiocytosis: Pharmacologic Rationale and Report of Two Cases

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Anti‐inflammatory and angiostatic therapy in chemorefractory multisystem Langerhans’ cell histiocytosis of adults

Cited by 36 publications

References 8 publications

New Indications for Established Drugs: Combined Tumor-Stroma-Targeted Cancer Therapy with PPAR&#947; Agonists, COX-2 Inhibitors, mTOR Antagonists and Metronomic Chemotherapy

New Indications for Established Drugs: Combined Tumor-Stroma-Targeted Cancer Therapy with PPAR&#947; Agonists, COX-2 Inhibitors, mTOR Antagonists and Metronomic Chemotherapy

Multisystemic Langerhans cell histiocytosis in an adult

Prostaglandin Inhibitors in the Treatment of Single-system Langerhans Cell Histiocytosis: Pharmacologic Rationale and Report of Two Cases

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Product

Resources

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New Indications for Established Drugs: Combined Tumor-Stroma-Targeted Cancer Therapy with PPARγ Agonists, COX-2 Inhibitors, mTOR Antagonists and Metronomic Chemotherapy

New Indications for Established Drugs: Combined Tumor-Stroma-Targeted Cancer Therapy with PPARγ Agonists, COX-2 Inhibitors, mTOR Antagonists and Metronomic Chemotherapy