Evidence map›Paper›PMID 39883895›Full record

ArticleJCO global oncology2025

Oral Cyclophosphamide for Patients With Metastatic Castration-Resistant Prostate Cancer in a Scenario of Limited Health Care Resources.

Diana Del Cisne Pineda, Gabriel Berlingieri Polho, Yumi Ricucci Shinkado, Gustavo Alves Contado, Nathalia de Souza Crusoe, Vivian Naomi Horita, Joao Carlos Resende, Jamile Almeida Silva, Guilherme Fialho de Freitas, David Queiroz Muniz and 4 more

Abstract read
In one paragraph

Article in JCO global oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Evaluation of [The Prostate · 2026
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Diana Del Cisne PinedaGenitourinary Medical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.
Gabriel Berlingieri PolhoGenitourinary Medical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.ORCID 0000-0003-2309-6175
Yumi Ricucci ShinkadoGenitourinary Medical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.ORCID 0000-0003-1286-6904
Gustavo Alves ContadoGenitourinary Medical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.
Nathalia de Souza CrusoeGenitourinary Medical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.
Vivian Naomi HoritaGenitourinary Medical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.
Joao Carlos ResendeGenitourinary Medical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.
Jamile Almeida SilvaGenitourinary Medical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.
Guilherme Fialho de FreitasGenitourinary Medical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.ORCID 0000-0002-9133-4086
David Queiroz MunizGenitourinary Medical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.ORCID 0000-0003-0661-7960
Caio V SuartzUrology, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.ORCID 0000-0002-1364-5508
Leopoldo Alves Ribeiro-FilhoUrology, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.ORCID 0000-0001-9732-6557
Paulo M HoffInstituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.ORCID 0000-0002-0065-2194
José Mauricio MotaGenitourinary Medical Oncology Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil.ORCID 0000-0001-9510-6956

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePrior noncontemporary studies showed that oral cyclophosphamide is an active treatment of metastatic castration-resistant prostate cancer (mCRPC). However, cyclophosphamide is currently underutilized in routine clinical practice given the lack of survival benefit and the emergence of more effective treatments.

methodsWe retrospectively reviewed our institutional database to identify patients with mCRPC treated with cyclophosphamide. Prostate-specific antigen decrease ≥50% from baseline (PSA50) response was determined as the proportion of patients achieving a prostate-specific antigen (PSA) decline ≥50% from baseline. Radiographic responses and progression were evaluated by Prostate Cancer Working Group 3. Survival estimates used the Kaplan-Meier method, and correlations were made with Chi-square test for categorical variables.

resultsFrom January 2011 to January 2023, 341 patients with mCRPC received oral cyclophosphamide at a tertiary cancer center in São Paulo, Brazil. The most common regimen (95%) was 100 mg once daily 21 days on, 7 days off. At prostate cancer diagnosis, the median age was 64.4 years (IQR, 59.4-70.8), 61.9% had metastatic de novo disease, and 55.5% had Gleason ≥8. The median number of previous treatment lines was three (IQR, 2-4). Any PSA decline was observed in 33.4%, and 13.2% had a PSA50 response. Median response duration was 2.1 months (IQR, 1.4-3.8). Ten patients (3%) were treated for ≥1 year. PSA50 response was associated with no prior docetaxel use and Eastern Cooperative Oncology Group performance status 0 or 1.

conclusionOral cyclophosphamide is a feasible treatment option for patients with mCRPC, particularly in a scenario of limited health care resources.

Indexed as

Antineoplastic Agents, AlkylatingCyclophosphamideProstatic Neoplasms, Castration-ResistantAdministration, OralAgedHealth ResourcesHumansMaleMiddle AgedNeoplasm MetastasisProstate-Specific AntigenRetrospective StudiesAntineoplastic Agents, AlkylatingCyclophosphamideProstate-Specific Antigen

Identifiers

PMID39883895
PMCPMC11892613

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.