Medical Oncology

, 36:80 | Cite as

Metronomic chemotherapy with cyclophosphamide plus low dose of corticosteroids in advanced castration-resistant prostate cancer across the era of taxanes and new hormonal drugs

  • Nicola CalvaniEmail author
  • Franco Morelli
  • Emanuele Naglieri
  • Antonio Gnoni
  • Vincenzo Emanuele Chiuri
  • Laura Orlando
  • Palma Fedele
  • Saverio Cinieri
Original Paper


The aim of our study is to investigate the efficacy of metronomic cyclophosphamide plus low dose of corticosteroids in advanced or metastatic castration-resistant prostate cancer (CRPC) before, between, and after standard chemotherapy, such as docetaxel and cabazitaxel, and new hormonal treatments, such as abiraterone and enzalutamide. A retrospective analysis was performed on 37 patients. Cyclophosphamide was given orally 50 mg per day together with low dose of corticosteroids, namely dexametasone orally 1 mg per day or prednisone 10 mg per day. Seventeen patients (51%) showed a PSA decline≥ 50%. Median progression-free survival (PFS) and overall survival (OS) were 11 and 28 months, respectively. Median PFS and OS in the subgroup of patients with a PSA decline ≥ 50% were 14 and 35 months, respectively. Treatment was very well tolerated. We suggest that oral metronomic cyclophosphamide plus low dose of oral dexamethasone or prednisone may be a good and safe therapeutic option not only in those CRPC patients unfit for standard treatments but also in those heavily pre-treated patients.


Prostate cancer Castration-resistant Cyclophosphamide Metronomic chemotherapy 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This study was approved by the Independent Medical Ethics Committee of ASL Brindisi. Because this was a retrospective study, formal consent was required only for those participants still alive at the time of data collection.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Medical Oncology Division and Breast UnitSen. Antonio Perrino HospitalBrindisiItaly
  2. 2.Department of OncologyIRCCS Casa Sollievo della SofferenzaSan Giovanni RotondoItaly
  3. 3.Medical Oncology UnitIRCCS Giovanni Paolo IIBariItaly
  4. 4.Medical Oncology UnitSacro Cuore di Gesù HospitalGallipoliItaly
  5. 5.Medical Oncology DepartmentV. Fazzi HospitalLecceItaly

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