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Metronomic chemotherapy for children in low- and middle-income countries: Survey of current practices and opinions of pediatric oncologists

Journal of Global Oncology Oct 15, 2019

Revon-Rivière G, Banavali S, Heississen L, et al. - Via an online questionnaire, researchers inquired more than 1,200 physicians in pediatric oncology networks in low- and middle-income countries (LMICs) in order to acquire knowledge on the experience, practices, opinions, and requirements in metronomics of physicians working in LMICs. Metronomics merges frequent administrations of low-dose chemotherapy with drug repurposing, which involves using already-approved drugs for new medical applications. Responses were given by 17% of the overall physicians. Findings revealed an already use of metronomics in LMICs. Metronomics represents a potential reply to unmet requirements in pediatric oncology. Celecoxib (44%) followed by propranolol and valproic acid (17%) were the most commonly cited repositioned drugs. The benefits of outpatient use were reported by 20% and low toxicity was expected by 24%. While taking into account the drawbacks of metronomics, the absence of scientific proof or guidelines was emphasized by 47% of responses. In addition, 33% and 18% of responses highlighted the availability or affordability of drugs and the problem of acceptance or compliance, respectively. The availability of drugs can be improved further and there is a need to develop collaborative protocols and research to produce level A evidence.
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