The anti-angiogenic basis of metronomic chemotherapy.

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Nat Rev Cancer. 2004 Jun;4(6):423-36.
The anti-angiogenic basis of metronomic chemotherapy.
Kerbel RS, Kamen BA.
In addition to proliferating cancer cells and various types of normal cells, such as those of thebone marrow, conventional cytotoxic chemotherapeutics affect the endothelium of the growingtumour vasculature. The anti-angiogenic efficacy of chemotherapy seems to be optimized byadministering comparatively low doses of drug on a frequent or continuous schedule, with noextended interruptions — sometimes referred to as ‘metronomic’ chemotherapy. In addition toreduced acute toxicity, the efficacy of metronomic chemotherapy seems to increase whenadministered in combination with specific anti-angiogenic drugs. Gaining better insight into themechanisms of these effects could lessen or even eliminate the empiricism used to determine theoptimal dose and schedule for metronomic chemotherapy regimens.