The effects of ciprofloxacin and paclitaxel on metastatic and recurrent chondrosarcoma

Edward J. Fox, MD, Jesse T. Torbert, MD, Anne-Marie Martin, PhD, Arthur P. Staddon, MD, Joseph L. Finstein, MD, and Richard D. Lackman, MD

Department of Orthopaedic Surgery, The University of Pennsylvania, Philadelphia, PA

Currently, the only treatment available for recurrent/metastatic chondrosarcoma is further surgical resection. Fluoroquinolones have shown toxicity in immature cartilage, inducing apoptosis and inhibiting the proliferation of human chondrosarcoma cells. Since previous studies suggested that ciprofloxacin and paclitaxel act synergistically in slowing the growth of chondrosarcoma in vitro, we investigated their effects on human recurrent/metastatic chondrosarcoma. Four patients received oral ciprofloxacin (750 mg twice daily) and intravenous paclitaxel (90 mg/m²) for 6–8 weeks of each cycle. Patient 1 remained stable 32.8 weeks after initiation of treatment. Patient 2 showed a 60% decrease in tumor growth but progressed by 10.3 weeks. Patient 3 progressed over 9 weeks, remained stable for 16 months, and then progressed after treatment with paclitaxel was discontinued. Patient 4 had three lesions: the recurrent lesion progressed despite treatment, showing an 8% increase in growth; one metastatic lesion remained stable (18 weeks), and the second metastatic lesion progressed. Gene expression profiling of normal articular cartilage and human chondrosarcoma cells exposed to ciprofloxacin showed differential expression of the genes DDX5, MYST2, ISGF3, APC, RPL3, EIF4G2, and ERH, all of which are involved in cell proliferation, cell-cycle regulation, or apoptosis.

Commun Oncol 2005;2:516–522 print e-mail full text 243 kb