{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:23:10Z","timestamp":1792808590042,"version":"4.5.0"},"reference-count":44,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Oncol"],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Medulloblastoma recurrence in patients who have previously received irradiation has a dismal prognosis and lacks a standard salvage regimen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the response rate of pediatric patients with medulloblastoma recurrence using an antiangiogenic metronomic combinatorial approach (Medulloblastoma European Multitarget Metronomic Anti-Angiogenic Trial [MEMMAT]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This phase 2, investigator-initiated, multicenter nonrandomized controlled trial assessed 40 patients with relapsed or refractory medulloblastoma without a ventriculoperitoneal shunt who were younger than 20 years at original diagnosis. Patients were enrolled between April 1, 2014, and March 31, 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Treatment consisted of daily oral thalidomide, fenofibrate, celecoxib, and alternating 21-day cycles of low-dose (metronomic) oral etoposide and cyclophosphamide, supplemented by intravenous bevacizumab and intraventricular therapy consisting of alternating etoposide and cytarabine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary end point was response after 6 months of antiangiogenic metronomic therapy. Secondary end points included progression-free survival (PFS), overall survival (OS), and quality of life. Adverse events were monitored to assess safety.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 40 patients (median [range] age at treatment start, 10 [4-17] years; 25 [62.5%] male) prospectively enrolled, 23 (57.5%) achieved disease control after 6 months of treatment, with a response detected in 18 patients (45.0%). Median OS was 25.5 months (range, 10.9-40.0 months), and median PFS was 8.5 months (range, 1.7-15.4 months). Mean (SD) PFS at both 3 and 5 years was 24.6% (7.9%), while mean (SD) OS at 3 and 5 years was 43.6% (8.5%) and 22.6% (8.8%), respectively. No significant differences in PFS or OS were evident based on molecular subgroup analysis or the number of prior recurrences. In patients demonstrating a response, mean (SD) overall 5-year PFS was 49.7% (14.3%), and for patients who remained progression free for the first 12 months of treatment, mean (SD) 5-year PFS was 66.7% (16.1%). Treatment was generally well tolerated. Grade 3 to 4 treatment-related adverse events included myelosuppression, infections, seizures, and headaches. One heavily pretreated patient with a third recurrence died of secondary acute myeloid leukemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This feasible and well-tolerated MEMMAT combination regimen demonstrated promising activity in patients with previously irradiated recurrent medulloblastoma. Given these results, this predominantly oral, well-tolerated, and outpatient treatment warrants further evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      ClinicalTrials.gov Identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT01356290\">NCT01356290<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaoncol.2023.4437","type":"journal-article","created":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T11:32:41Z","timestamp":1698319961000},"page":"1688","source":"Crossref","is-referenced-by-count":55,"title":["Sustained Survival Benefit in Recurrent Medulloblastoma by a Metronomic Antiangiogenic Regimen"],"prefix":"10.1001","volume":"9","author":[{"given":"Andreas","family":"Peyrl","sequence":"first","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika","family":"Chocholous","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Sabel","sequence":"additional","affiliation":[{"name":"Childhood Cancer Centre, Queen Silvia Children\u2019s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden"},{"name":"Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvaro","family":"Lassaletta","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neuro-Oncology, Hospital Infantil Universitario Ni\u00f1o Jes\u00fas, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaroslav","family":"Sterba","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Department, University Hospital Brno, Brno, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Leblond","sequence":"additional","affiliation":[{"name":"Pediatric Oncology Unit, Oscar Lambret Comprehensive Cancer Center, Lille, France"},{"name":"Centre L\u00e9on B\u00e9rard, Institut d\u2019H\u00e9matologie et d\u2019Oncologie Pediatrique, Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karsten","family":"Nysom","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Torsvik","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Adolescent Medicine, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan N.","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Perwein","sequence":"additional","affiliation":[{"name":"Division of Pediatric Hemato-Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Jones","sequence":"additional","affiliation":[{"name":"Kinderonkologie, Salzburger Universit\u00e4tsklinikum, Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Holm","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Nyman","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Link\u00f6ping University Hospital, Link\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"M\u00f6rse","sequence":"additional","affiliation":[{"name":"Pediatric Cancer Center, Skane University Hospital, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"\u00d6berg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liesa","family":"Weiler-Wichtl","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrike","family":"Leiss","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Haberler","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maresa T.","family":"Schmook","sequence":"additional","affiliation":[{"name":"Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Mayr","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Dieckmann","sequence":"additional","affiliation":[{"name":"Department of Radio-Oncology, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"Kool","sequence":"additional","affiliation":[{"name":"Hopp Children\u2019s Cancer Center (KiTZ), Heidelberg, Germany"},{"name":"Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Heidelberg, Germany"},{"name":"Princess M\u00e1xima Center for Pediatric Oncology, Utrecht, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Gojo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amedeo A.","family":"Azizi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"D\u00e9partment of Pediatric Oncology, Assistance Publique-Hopitaux de Marseille, Marseille, France"},{"name":"Aix Marseille University, Cancer Research Center of Marseille, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Kieran","sequence":"additional","affiliation":[{"name":"Department of Pediatric Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Slavc","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria"},{"name":"Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"key":"coi230057r1","doi-asserted-by":"publisher","first-page":"iii1","DOI":"10.1093\/neuonc\/noac161","article-title":"CBTRUS statistical report: Pediatric Brain Tumor Foundation Childhood and Adolescent Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2014-2018.","volume":"24","author":"Ostrom","year":"2022","journal-title":"Neuro Oncol"},{"issue":"4","key":"coi230057r2","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1007\/s00401-011-0922-z","article-title":"Molecular subgroups of medulloblastoma: the current consensus.","volume":"123","author":"Taylor","year":"2012","journal-title":"Acta Neuropathol"},{"issue":"7","key":"coi230057r3","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1016\/S1470-2045(17)30243-7","article-title":"Novel molecular subgroups for clinical classification and outcome prediction in childhood medulloblastoma: a cohort study.","volume":"18","author":"Schwalbe","year":"2017","journal-title":"Lancet Oncol"},{"issue":"2","key":"coi230057r4","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1007\/s00401-019-02020-0","article-title":"Second-generation molecular subgrouping of medulloblastoma: an international meta-analysis of Group 3 and Group 4 subtypes.","volume":"138","author":"Sharma","year":"2019","journal-title":"Acta Neuropathol"},{"issue":"8","key":"coi230057r5","doi-asserted-by":"publisher","first-page":"1231","DOI":"10.1093\/neuonc\/noab106","article-title":"The 2021 WHO Classification of Tumors of the Central Nervous System: a summary.","volume":"23","author":"Louis","year":"2021","journal-title":"Neuro Oncol"},{"issue":"12","key":"coi230057r6","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1016\/S1470-2045(13)70449-2","article-title":"Recurrence patterns across medulloblastoma subgroups: an integrated clinical and molecular analysis.","volume":"14","author":"Ramaswamy","year":"2013","journal-title":"Lancet Oncol"},{"issue":"9","key":"coi230057r7","doi-asserted-by":"publisher","first-page":"1389","DOI":"10.1016\/j.ejca.2011.03.004","article-title":"Treatment of recurrent central nervous system primitive neuroectodermal tumours in children and adolescents: results of a Children\u2019s Cancer and Leukaemia Group study.","volume":"47","author":"Pizer","year":"2011","journal-title":"Eur J Cancer"},{"issue":"3","key":"coi230057r8","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1007\/s11060-016-2202-1","article-title":"Relapse patterns and outcome after relapse in standard risk medulloblastoma: a report from the HIT-SIOP-PNET4 study.","volume":"129","author":"Sabel","year":"2016","journal-title":"J Neurooncol"},{"issue":"12","key":"coi230057r9","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1016\/S2352-4642(20)30246-7","article-title":"Time, pattern, and outcome of medulloblastoma relapse and their association with tumour biology at diagnosis and therapy: a multicentre cohort study.","volume":"4","author":"Hill","year":"2020","journal-title":"Lancet Child Adolesc Health"},{"issue":"7","key":"coi230057r10","doi-asserted-by":"publisher","first-page":"807","DOI":"10.1200\/JCO.20.01359","article-title":"Clinical outcomes and patient-matched molecular composition of relapsed medulloblastoma.","volume":"39","author":"Kumar","year":"2021","journal-title":"J Clin Oncol"},{"issue":"1","key":"coi230057r11","doi-asserted-by":"publisher","first-page":"53","DOI":"10.3390\/cancers13010053","article-title":"Prognostic clinical and biologic features for overall survival after relapse in childhood medulloblastoma.","volume":"13","author":"Huybrechts","year":"2020","journal-title":"Cancers (Basel)"},{"issue":"1","key":"coi230057r12","doi-asserted-by":"publisher","first-page":"126","DOI":"10.3390\/cancers14010126","article-title":"Relapsed medulloblastoma in pre-irradiated patients: current practice for diagnostics and treatment.","volume":"14","author":"Hill","year":"2021","journal-title":"Cancers (Basel)"},{"issue":"9","key":"coi230057r13","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1093\/neuonc\/not097","article-title":"Phase II study of irinotecan in combination with temozolomide (TEMIRI) in children with recurrent or refractory medulloblastoma: a joint ITCC and SIOPE brain tumor study.","volume":"15","author":"Grill","year":"2013","journal-title":"Neuro Oncol"},{"issue":"8","key":"coi230057r14","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.v68.8","article-title":"Temozolomide with irinotecan versus temozolomide, irinotecan plus bevacizumab for recurrent medulloblastoma of childhood: report of a COG randomized Phase II screening trial.","volume":"68","author":"Levy","year":"2021","journal-title":"Pediatr Blood Cancer"},{"issue":"7","key":"coi230057r15","first-page":"1878","article-title":"Antiangiogenic scheduling of chemotherapy improves efficacy against experimental drug-resistant cancer.","volume":"60","author":"Browder","year":"2000","journal-title":"Cancer Res"},{"issue":"5","key":"coi230057r16","doi-asserted-by":"publisher","first-page":"739","DOI":"10.3892\/etm.2010.127","article-title":"Inhibition of tumor angiogenesis by oral etoposide.","volume":"1","author":"Panigrahy","year":"2010","journal-title":"Exp Ther Med"},{"issue":"6","key":"coi230057r17","doi-asserted-by":"publisher","first-page":"1922","DOI":"10.1200\/JCO.1996.14.6.1922","article-title":"Response of recurrent medulloblastoma to low-dose oral etoposide.","volume":"14","author":"Ashley","year":"1996","journal-title":"J Clin Oncol"},{"issue":"3","key":"coi230057r18","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1073\/pnas.0711281105","article-title":"PPARa agonist fenofibrate suppresses tumor growth through direct and indirect angiogenesis inhibition.","volume":"105","author":"Panigrahy","year":"2008","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"30","key":"coi230057r19","doi-asserted-by":"publisher","first-page":"11127","DOI":"10.1073\/pnas.1410432111","article-title":"Dual inhibition of cyclooxygenase-2 and soluble epoxide hydrolase synergistically suppresses primary tumor growth and metastasis.","volume":"111","author":"Zhang","year":"2014","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"9","key":"coi230057r20","doi-asserted-by":"publisher","first-page":"4082","DOI":"10.1073\/pnas.91.9.4082","article-title":"Thalidomide is an inhibitor of angiogenesis.","volume":"91","author":"D\u2019Amato","year":"1994","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"20","key":"coi230057r21","doi-asserted-by":"publisher","first-page":"5128","DOI":"10.3390\/cancers14205128","article-title":"Improved long-term survival of patients with recurrent medulloblastoma treated with a \u201cMEMMAT-like\u201d metronomic antiangiogenic approach.","volume":"14","author":"Slavc","year":"2022","journal-title":"Cancers (Basel)"},{"issue":"3","key":"coi230057r22","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1002\/pbc.v59.3","article-title":"Antiangiogenic metronomic therapy for children with recurrent embryonal brain tumors.","volume":"59","author":"Peyrl","year":"2012","journal-title":"Pediatr Blood Cancer"},{"issue":"20","key":"coi230057r23","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2013.281053","article-title":"World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects.","volume":"310","author":"World Medical Association","year":"2013","journal-title":"JAMA"},{"issue":"7697","key":"coi230057r24","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1038\/nature26000","article-title":"DNA methylation-based classification of central nervous system tumours.","volume":"555","author":"Capper","year":"2018","journal-title":"Nature"},{"issue":"5","key":"coi230057r25","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1023\/A:1008853819715","article-title":"Assessing health-related quality of life in chronically ill children with the German KINDL: first psychometric and content analytical results.","volume":"7","author":"Ravens-Sieberer","year":"1998","journal-title":"Qual Life Res"},{"issue":"1","key":"coi230057r26","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.cct.2007.04.008","article-title":"Optimal and minimax three-stage designs for phase II oncology clinical trials.","volume":"29","author":"Chen","year":"2008","journal-title":"Contemp Clin Trials"},{"issue":"1","key":"coi230057r27","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.v67.1","article-title":"Phase II study of temozolomide and topotecan (TOTEM) in children with relapsed or refractory extracranial and central nervous system tumors including medulloblastoma with post hoc Bayesian analysis: a European ITCC study.","volume":"67","author":"Le Teuff","year":"2020","journal-title":"Pediatr Blood Cancer"},{"issue":"10","key":"coi230057r28","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1200\/JCO.21.02968","article-title":"Outcomes of infants and young children with relapsed medulloblastoma after initial craniospinal irradiation-sparing approaches: an international cohort study.","volume":"41","author":"Erker","year":"2023","journal-title":"J Clin Oncol"},{"issue":"1","key":"coi230057r29","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1002\/cncr.v110:1","article-title":"High-dose chemotherapy with autologous stem cell rescue followed by posterior fossa irradiation for local medulloblastoma recurrence or progression after conventional chemotherapy.","volume":"110","author":"Ridola","year":"2007","journal-title":"Cancer"},{"issue":"4","key":"coi230057r30","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1002\/pbc.v54:4","article-title":"Role of high-dose chemotherapy for recurrent medulloblastoma and other CNS primitive neuroectodermal tumors.","volume":"54","author":"Gajjar","year":"2010","journal-title":"Pediatr Blood Cancer"},{"issue":"1","key":"coi230057r31","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1200\/JCO.1998.16.1.222","article-title":"High-dose carboplatin, thiotepa, and etoposide with autologous stem-cell rescue for patients with recurrent medulloblastoma.","volume":"16","author":"Dunkel","year":"1998","journal-title":"J Clin Oncol"},{"issue":"1","key":"coi230057r32","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1007\/s11060-019-03272-2","article-title":"Re-irradiation for children with recurrent medulloblastoma in Toronto, Canada: a 20-year experience.","volume":"145","author":"Tsang","year":"2019","journal-title":"J Neurooncol"},{"issue":"5","key":"coi230057r33","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1007\/s00262-006-0225-8","article-title":"Metronomic cyclophosphamide regimen selectively depletes CD4+CD25+ regulatory T cells and restores T and NK effector functions in end stage cancer patients.","volume":"56","author":"Ghiringhelli","year":"2007","journal-title":"Cancer Immunol Immunother"},{"issue":"1","key":"coi230057r34","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1038\/s41572-019-0141-9","article-title":"Lupus nephritis.","volume":"6","author":"Anders","year":"2020","journal-title":"Nat Rev Dis Primers"},{"issue":"2","key":"coi230057r35","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1007\/s00467-021-04983-3","article-title":"Update on the treatment of steroid-sensitive nephrotic syndrome.","volume":"37","author":"Zotta","year":"2022","journal-title":"Pediatr Nephrol"},{"issue":"7","key":"coi230057r36","first-page":"308","article-title":"Combined biodifferentiating and antiangiogenic oral metronomic therapy is feasible and effective in relapsed solid tumors in children: single-center pilot study.","volume":"29","author":"Sterba","year":"2006","journal-title":"Onkologie"},{"issue":"5","key":"coi230057r37","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1159\/000336483","article-title":"Metronomic chemotherapy with the COMBAT regimen in advanced pediatric malignancies: a multicenter experience.","volume":"82","author":"Zapletalova","year":"2012","journal-title":"Oncology"},{"issue":"4","key":"coi230057r38","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1002\/pbc.v61.4","article-title":"A phase II trial of a multi-agent oral antiangiogenic (metronomic) regimen in children with recurrent or progressive cancer.","volume":"61","author":"Robison","year":"2014","journal-title":"Pediatr Blood Cancer"},{"issue":"11","key":"coi230057r39","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1097\/01.mph.0000183863.10792.d4","article-title":"A feasibility trial of antiangiogenic (metronomic) chemotherapy in pediatric patients with recurrent or progressive cancer.","volume":"27","author":"Kieran","year":"2005","journal-title":"J Pediatr Hematol Oncol"},{"issue":"9","key":"coi230057r40","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.v67.9","article-title":"Metro-SMHOP 01: metronomics combination with cyclophosphamide-etoposide and valproic acid for refractory and relapsing pediatric malignancies.","volume":"67","author":"El Kababri","year":"2020","journal-title":"Pediatr Blood Cancer"},{"issue":"8","key":"coi230057r41","doi-asserted-by":"publisher","first-page":"946","DOI":"10.1111\/apa.2016.105.issue-8","article-title":"Metronomic therapy can increase quality of life during paediatric palliative cancer care, but careful patient selection is essential.","volume":"105","author":"Porkholm","year":"2016","journal-title":"Acta Paediatr"},{"issue":"3","key":"coi230057r42","doi-asserted-by":"publisher","first-page":"471","DOI":"10.3390\/cancers14030471","article-title":"Local and systemic therapy of recurrent medulloblastomas in children and adolescents: results of the P-HIT-REZ 2005 study.","volume":"14","author":"Gaab","year":"2022","journal-title":"Cancers (Basel)"},{"issue":"6","key":"coi230057r43","doi-asserted-by":"publisher","first-page":"768","DOI":"10.1016\/S1470-2045(18)30204-3","article-title":"Risk-adapted therapy for young children with medulloblastoma (SJYC07): therapeutic and molecular outcomes from a multicentre, phase 2 trial.","volume":"19","author":"Robinson","year":"2018","journal-title":"Lancet Oncol"},{"issue":"10","key":"coi230057r44","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1016\/j.trecan.2020.05.007","article-title":"Metronomic maintenance for high-risk pediatric malignancies: one size will not fit all.","volume":"6","author":"Andr\u00e9","year":"2020","journal-title":"Trends Cancer"}],"container-title":["JAMA Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/articlepdf\/2811045\/jamaoncology_peyrl_2023_oi_230057_1702491808.511.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T11:02:07Z","timestamp":1703156527000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaoncology\/fullarticle\/2811045"}},"subtitle":["A Nonrandomized Controlled Trial"],"short-title":[],"issued":{"date-parts":[[2023,12,1]]},"references-count":44,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoncol.2023.4437","relation":{},"ISSN":["2374-2437"],"issn-type":[{"value":"2374-2437","type":"print"}],"subject":[],"published":{"date-parts":[[2023,12,1]]}}}