Rationale for the use of metronomic chemotherapy in gastrointestinal cancer.

Abstract

INTRODUCTION:

Metronomic chemotherapy (mCT) is endowed with various properties, ranging from antiangiogenic to immunomodulation, and may revert tumor resistance to conventional drug administration. A variety of antineoplastic agents displayed activity when administered with metronomic schedules in preclinical models of gastrointestinal cancers. However, most of the field is still unexplored.

AREAS COVERED:

Herein, the authors review the existing literature from PubMed, concerning the use of mCT in gastrointestinal oncology.

EXPERT OPINION:

A mounting body of evidence is emerging in support of mCT as a treatment option for gastrointestinal tumors, but the frequent signs of clinical activity inconsistently translate into a benefit for survival. Research in this field should focus on providing high-quality evidence on the safety and efficacy of mCT, with more prospective, comparative trials; identifying the subgroups of patients for whom mCT would be the best approach; establishing standardized protocols based on mCT pharmacokinetics and pharmacodynamics; developing drug activity biomarkers. mCT is also potentially suitable for combinations with targeted antiangiogenic drugs and may be incorporated with conventional administration into dual regimens.

• Authors: Roberto Filippi, Pasquale Lombardi, Ilaria Depetris, Elisabetta Fenocchio, Virginia Quarà, Giovanna Chilà, Massimo Aglietta, Francesco Leone
• Journal: Expert opinion on pharmacotherapy (Expert Opin Pharmacother) Vol. 19 Issue 13 Pg. 1451-1463 (09 2018) ISSN: 1744-7666 [Electronic] England
• PMID: 30161003 (Publication Type: Journal Article, Review)

Chemical References

• Angiogenesis Inhibitors
• Antineoplastic Agents

Topics

• Angiogenesis Inhibitors (administration & dosage, therapeutic use)
• Animals
• Antineoplastic Agents (administration & dosage, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Gastrointestinal Neoplasms (drug therapy)
• Humans