Celecoxib-Myrtol prolongs survival in appendiceal mucinous neoplasma with peritoneal spread

A novel combination of celecoxib and Myrtol for recurrent appendiceal mucinous neoplasma (AMN) with extensive peritoneal dissemination is well tolerated and appears to extend progression-free (PFS) and overall survival (OS) in patients, a recent study has found.

“Unresectable AMNs with extensive peritoneal dissemination cause significant morbidity and have limited treatment options,” the authors said.

Recurrent AMN patients with extensive peritoneal disease treated with a regimen of 200-mg celecoxib and 1,200-mg Myrtol standardized daily were recruited for this study. The authors then calculated PFS and OS and compared carcinoembryonic antigen (CEA) trends pre- and post-treatment in terms of percentage change.

Between 2017 and 2020, 13 patients (median age 63 years, interquartile range 55‒67, 54 percent male) with extensive, recurrent disease (median peritoneal carcinomatosis index of 36) were included.

Eighty-five percent had undergone prior cytoreductive surgery, and 15 percent underwent cytoreductive surgery at least twice. More than half (54 percent) had received multiple cycles of systemic chemotherapy prior to celecoxib-Myrtol initiation.

Median PFS was 16 months (interquartile range 5‒17) and OS 27 months after a median follow-up of 8 months. Nine patients (69.2 percent) saw improvement in CEA values 3 months after treatment relative to 3-month pretreatment CEA trends. No treatment-related adverse events were observed.

“Our feasibility study suggests that a regimen of celecoxib-Myrtol is well tolerated and may prolong PFS and OS in patients with recurrent AMNs with peritoneal spread,” the authors said.