Metronomic chemotherapy: changing the paradigm that more is better.

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Curr Oncol. 2009 Mar;16(2):7-15.

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Metronomic chemotherapy: changing the paradigm that more is better.

Scharovsky OG, Mainetti LE, Rozados VR.
Instituto de Genética Experimental, Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Argentina.
 
The
introduction of the "maximum tolerated dose" in usual treatment
protocols (and its concomitant overt toxicity) made necessary the
imposition of rest periods between cycles of therapy-a practice that
not only involves re-growth of tumour cells, but also growth of
selected clones resistant to the therapy. To avoid the problems caused
by traditional chemotherapeutic regimens, a new modality of drug
administration called "metronomic chemotherapy" has been proposed. This
name makes reference to the chronic, equally spaced administration of
(generally) low doses of various chemotherapeutic drugs without
extended rest periods. The novelty of this treatment modality lies not
only in its antitumour efficacy with very low toxicity, but also in a
cell target switch, now aiming at tumour endothelial cells. The
knowledge acquired in the experimental field of metronomic
chemotherapy, plus the increasing experience that is being obtained in
the clinical setting, will help to lead a change in the design of
therapeutic protocols against cancer.