Metronomic Chemotherapy: A Relook At Its Basis and Rationale

• Published in: Cancer letters Vol. 388; pp. 328 - 333
• Main Authors: Rajasekaran, Tanujaa, Ng, Quan-Sing, Shao-Weng Tan, Daniel, Lim, Wan-Teck, Ang, Mei-Kim, Toh, Chee-Keong, Chowbay, Balram, Kanesvaran, Ravindran, Tan, Eng-Huat
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.03.2017; Elsevier Limited
• Subjects: Administration, Metronomic; Anemia; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers; Cancer; Cancer therapies; Chemotherapy; Cytotoxicity; Definition of metronomic chemotherapy; Drug dosages; Hematology, Oncology and Palliative Medicine; Humans; Immunotherapy; Lung cancer; Metronomic chemotherapy; Neoplasms - drug therapy; Neutropenia; Prostate; Response rates; Schedules; Biomarkers; Metronomic chemotherapy; Definition of metronomic chemotherapy; Cancer
• ISSN: 0304-3835; 1872-7980
• DOI: 10.1016/j.canlet.2016.12.013

Abstract Metronomic administration of chemotherapy has long been recognized as having a different biological effect from maximal tolerated dose (MTD) administration. Preclinical studies have demonstrated these differences quite elegantly and many clinical trials have also demonstrated reproducible activity albeit small, in varied solid malignancies even in patients who were heavily pretreated. However, the concept of metronomic chemotherapy has been plagued by lack of a clear definition resulting in the published literature that is rather varied and confusing. There is a need for a definition that is mechanism(s)-based allowing metronomics to be distinguished from standard MTD concept. With significant advances made in understanding cancer biology and biotechnology, it is now possible to attain that goal. What is needed is both a concerted effort and adequate funding to work towards it. This is the only way for the oncology community to determine how metronomic chemotherapy fits in the overall cancer management schema.