Real-World Activity and Safety of Metronomic Cyclophosphamide in Advanced Soft-Tissue Sarcoma: The Multicenter MeRCY Study
6 affiliations
- 1Department of Medical Oncology, Besançon University Hospital (CHU Jean Minjoz), 25000 Besançon, France
- 2Université Marie et Louis Pasteur, EFS, INSERM, UMR RIGHT, 25000 Besançon, France
- 3Methodology and Quality of Life in Oncology Unit, Besançon University Hospital, 25000 Besançon, France
- 4Department of Pediatric Oncology and Hematology, Besançon University Hospital, 25000 Besançon, France
- 5Département D’oncologie Médicale, Chirurgie et Radiothérapie, Centre Georges-François Leclerc, Unicancer, Université Bourgogne Europe, 21000 Dijon, France
- 6Department of Medical Oncology, Poitiers University Hospital, 86000 Poitiers, France
Abstract
Background/Objectives: Metronomic cyclophosphamide (MCP) is sometimes used for advanced soft-tissue sarcoma (STS) when standard therapies are unsuitable. We assessed its activity and safety in routine practice. Methods: This French three-center retrospective study included 60 adults with unresectable or metastatic STS who started MCP in 2008–2021. Patients received oral cyclophosphamide 50 mg twice daily on days 1–7 of 14-day cycles; 12 (20%) also received prednisolone during treatment weeks. The primary endpoint was progression-free survival (PFS). Results: Median age was 70 years; 55% had ECOG performance status 2–3. Median PFS and overall survival (OS) were 2.6 months (95% CI, 1.8–3.6) and 6.4 months (95% CI, 4.2–9.3), respectively. The objective response rate was 5.0% (3/60; exact 95% CI, 1.0–13.9%) and the disease control rate was 21.7% (13/60; exact 95% CI, 12.1–34.2%); ten patients (16.7%) were not radiologically evaluable. In 21 patients aged >65 years treated in the first- or second-line setting, median PFS and OS were 3.2 and 7.7 months. Treatment-related adverse events were documented in 16 patients (26.7%), with no grade ≥3 events recorded. Conclusions: Intermittent low-dose MCP showed limited antitumor activity but favorable clinician-documented short-term tolerability in this multicenter cohort. Alongside prospective evidence, the results do not support routine use in unselected patients. MCP may retain an individualized palliative role when established systemic therapy is unsuitable.
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BibTeX
@article{bolognini2026realworld,
title = {{Real-World Activity and Safety of Metronomic Cyclophosphamide in Advanced Soft-Tissue Sarcoma: The Multicenter MeRCY Study}},
author = {Clément Bolognini and Antoine Falcoz and Pauline Simon and Fabien Calcagno and Alice Hervieu and Nicolas Isambert and Isabelle Desmoulins and Sylvain Causeret and David Thibouw and Elsa Kalbacher and Guillaume Meynard and Dewi Vernerey and Loïc Chaigneau},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18213497},
url = {https://www.mdpi.com/2072-6694/18/21/3497},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Real-World Activity and Safety of Metronomic Cyclophosphamide in Advanced Soft-Tissue Sarcoma: The Multicenter MeRCY Study
AU - Clément Bolognini
AU - Antoine Falcoz
AU - Pauline Simon
AU - Fabien Calcagno
AU - Alice Hervieu
AU - Nicolas Isambert
AU - Isabelle Desmoulins
AU - Sylvain Causeret
AU - David Thibouw
AU - Elsa Kalbacher
AU - Guillaume Meynard
AU - Dewi Vernerey
AU - Loïc Chaigneau
PY - 2026
DA - 2026/10/30
JO - Cancers
DO - 10.3390/cancers18213497
UR - https://www.mdpi.com/2072-6694/18/21/3497
AB - Background/Objectives: Metronomic cyclophosphamide (MCP) is sometimes used for advanced soft-tissue sarcoma (STS) when standard therapies are unsuitable. We assessed its activity and safety in routine practice. Methods: This French three-center retrospective study included 60 adults with unresectable or metastatic STS who started MCP in 2008–2021. Patients received oral cyclophosphamide 50 mg twice daily on days 1–7 of 14-day cycles; 12 (20%) also received prednisolone during treatment weeks. The primary endpoint was progression-free survival (PFS). Results: Median age was 70 years; 55% had ECOG performance status 2–3. Median PFS and overall survival (OS) were 2.6 months (95% CI, 1.8–3.6) and 6.4 months (95% CI, 4.2–9.3), respectively. The objective response rate was 5.0% (3/60; exact 95% CI, 1.0–13.9%) and the disease control rate was 21.7% (13/60; exact 95% CI, 12.1–34.2%); ten patients (16.7%) were not radiologically evaluable. In 21 patients aged >65 years treated in the first- or second-line setting, median PFS and OS were 3.2 and 7.7 months. Treatment-related adverse events were documented in 16 patients (26.7%), with no grade ≥3 events recorded. Conclusions: Intermittent low-dose MCP showed limited antitumor activity but favorable clinician-documented short-term tolerability in this multicenter cohort. Alongside prospective evidence, the results do not support routine use in unselected patients. MCP may retain an individualized palliative role when established systemic therapy is unsuitable.
SN - 2072-6694
ER -