Did you mean: 'metronomic chemotherapy'
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Journal of Oncology 2019Metronomic chemotherapy, continuous and dose-dense administration of chemotherapeutic drugs with lowered doses, is being evaluated for substituting, augmenting, or... (Review)
Review
Metronomic chemotherapy, continuous and dose-dense administration of chemotherapeutic drugs with lowered doses, is being evaluated for substituting, augmenting, or appending conventional maximum tolerated dose regimens, with preclinical and clinical studies for the past few decades. To date, the principle mechanisms of its action include impeding tumoral angiogenesis and modulation of hosts' immune system, affecting directly tumor cells, their progenitors, and neighboring stromal cells. Its better toxicity profile, lower cost, and easier use are main advantages over conventional therapies. The evidence of metronomic chemotherapy for personalized medicine is growing, starting with unfit elderly patients and also for palliative treatment. The literature reviewed in this article mainly demonstrates that metronomic chemotherapy is advantageous for selected patients and for certain types of malignancies, which make it a promising therapeutic approach for filling in the gaps. More clinical studies are needed to establish a solidified role for metronomic chemotherapy with other treatment models in modern cancer management.
PubMed: 31015835
DOI: 10.1155/2019/5483791 -
Geburtshilfe Und Frauenheilkunde May 2016Conventional chemotherapy is generally administered in high doses followed by a treatment-free period to give the body needful time to recover. This "maximum tolerated... (Review)
Review
Conventional chemotherapy is generally administered in high doses followed by a treatment-free period to give the body needful time to recover. This "maximum tolerated dose" approach results in high response rates. However, long periods between therapy cycles can lead to development of resistance mechanisms and consequently disease progression. One of the most interesting alternative strategies is metronomic chemotherapy. This concept relies on the continuous administration of chemotherapy at low doses and aims at targeting endothelial cells in the tumor bed as well. Recently, metronomic chemotherapy has been incorporated into the recommendations issued by the German AGO expert panel (www.ago-online.de). A systematic review of PubMed/Medline, ClinicalTrials.gov, the European Clinical Trials Database (EudraCT) and the Cochrane Database was conducted. In the present review, we discuss the current evidence on metronomic chemotherapy in metastatic breast cancer.
PubMed: 27239061
DOI: 10.1055/s-0042-105871 -
Medicine Nov 2022The current studies on metronomic chemotherapy in mCRC are all aimed at patients after multi-line therapy failure, and only a few studies have focused on maintenance...
BACKGROUND
The current studies on metronomic chemotherapy in mCRC are all aimed at patients after multi-line therapy failure, and only a few studies have focused on maintenance treatment after successful first-line therapy.
METHODS
The PubMed, Embase, Cochrane Library, Wanfang, CNKI, and VIP were searched, and the relevant data was extracted, including media progression-free survival (mPFS), media overall survival (mOS), and grade 3/4 adverse events (AEs).
RESULTS
We included 4 randomized controlled trials (RCTs), 2 RCTs showed that metronomic maintenance chemotherapy could significantly improve mPFS compared to observation group; another RCT showed that metronomic maintenance chemotherapy group did not have low mPFS than the bevacizumab maintenance treatment (MT). The final RCT showed that dual-agent metronomic chemotherapy combined with bevacizumab MT did not improve mPFS compared with bevacizumab MT. The 3 RCTs showed that the metronomic maintenance therapy could not effectively improve mOS in mCRC compared to observation group or bevacizumab MT, while another RCT reported that the mOS in metronomic maintenance chemotherapy group was similar to bevacizumab MT. AEs was mostly mild and manageable. Grade ≥ 3 AEs are mostly nonhematological toxicity, and no deaths related to AEs were reported.
CONCLUSION
This systematic review indicates that metronomic chemotherapy for mCRC MT can improve mPFS in some patients and is relatively safe. However, improvements in OS in most RCTs are arguable. Therefore, we need further studies to verify its long-term efficacy.
Topics: Humans; Bevacizumab; Colorectal Neoplasms; Randomized Controlled Trials as Topic; Colonic Neoplasms; Rectal Neoplasms; Lymphoma, Follicular
PubMed: 36401426
DOI: 10.1097/MD.0000000000031659 -
Geburtshilfe Und Frauenheilkunde Feb 2017Conventional chemotherapy is based on the "maximum tolerated dose" principle and aims at administering high doses of cytotoxic drugs followed by a rest period necessary...
Conventional chemotherapy is based on the "maximum tolerated dose" principle and aims at administering high doses of cytotoxic drugs followed by a rest period necessary for the body to recover. In the last decades alternative strategies have been developed to avoid serious side effects of conventional treatment, among them the metronomic chemotherapy. Much like a metronome keeps steady rhythm, metronomic therapy is administered continuously in low doses for a long time. In metastatic breast cancer, metronomic therapy is a valid option in pretreated or vulnerable patients and its use has recently been incorporated into various guidelines. In early breast cancer, the role of metronomic treatment remains to be clarified. A systematic review of PubMed/MEDLINE, ClinicalTrials.gov, the European Clinical Trials Database (EudraCT) and the Cochrane Database was conducted. In the present review, we discuss the current evidence on metronomic chemotherapy in non-metastatic breast cancer.
PubMed: 28331236
DOI: 10.1055/s-0043-100388 -
European Journal of Breast Health Jan 2018Oral etoposide has been used as a later line therapy for metastatic breast cancer for more than twenty years. Its efficacy and clinical usefulness has been suggested in...
OBJECTIVE
Oral etoposide has been used as a later line therapy for metastatic breast cancer for more than twenty years. Its efficacy and clinical usefulness has been suggested in small phase II studies in the metastatic breast cancer population and the drug has also the added advantage of convenient oral administration. Despite these advantages, the place of oral etoposide in treatment of metastatic breast cancer has been challenged in the last decade due to introduction of several other chemotherapeutics, including options available orally, as well as novel targeted therapies. This report pools the data on response rates and survival from all available oral etoposide studies in order to reach a more precise estimate of the clinical benefit of the drug.
MATERIALS AND METHODS
A review of the literature was performed for studies of oral etoposide in metastatic breast cancer. Data were extracted from eligible studies and summary statistics derived. Calculations of pooled response rates and survival estimates were performed according to a random or fixed effect model as appropriate.
RESULTS
The pooled estimate of Response Rate derived from twelve studies found in the English literature was 18.5% (95% CI 11.5-25.5%). The pooled estimate of Clinical Benefit Rate (CBR) was 45.8% (95% CI 38.6-53.0%) and median Overall Survival (OS) approached 1 year. Summarized adverse effects profile data show an overall manageable toxicity.
CONCLUSION
This pooled analysis provides evidence of a moderate clinical effectiveness of oral etoposide in metastatic breast cancer that could be useful in situations that options are limited but active treatment still appropriate.
PubMed: 29322113
DOI: 10.5152/ejbh.2017.3563