Metronomic chemotherapy: A relook at its basis and rationale. (1st March 2017)

• Record Type: Journal Article
• Authors: Rajasekaran, Tanujaa; Ng, Quan-Sing; Tan, Daniel Shao-Weng; Lim, Wan-Teck; Ang, Mei-Kim; Toh, Chee-Keong; Chowbay, Balram; Kanesvaran, Ravindran; Tan, Eng-Huat
• Is Part Of: Cancer letters. Volume 388(2017)
• Page Start: 328
• Page End: 333
• Publication Date: 2017-03-01
• Subjects: Metronomic chemotherapy -- Cancer -- Definition of metronomic chemotherapy -- Biomarkers; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Electronic journals; 616.994
• DOI: 10.1016/j.canlet.2016.12.013
• Languages: English
• ISSNs: 0304-3835

Abstract

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. Highlights: Metronomic chemotherapy is efficacious but role in cancer management is unclear. The concept of metronomic chemotherapy is plagued by lack of a clear definition. A mechanistic definition is feasible with more concerted efforts and funding. Biomarkers are needed to derive the optimal metronomic dosing of cytotoxics.