Metronomic Chemotherapy

What is Metronomic Chemotherapy?

Metronomic chemotherapy is a type of cancer treatment that involves giving lower, more frequent doses of chemotherapy drugs over an extended period, often without long breaks between cycles.

Unlike traditional chemotherapy, which typically involves higher doses given at specific intervals, metronomic chemotherapy aims to continuously target cancer cells with lower doses, reducing the toxic effects on normal cells.

This type of treatment is also thought to be more cost-effective because it involves a lower dose of drugs as compared to traditional chemotherapy.

Metronomic chemotherapy involves targeting the blood vessels that support tumor growth, disrupting their formation, and limiting the blood supply to the cancer cells. This can help slow down tumor growth and reduce the risk of resistance to treatment.

Metronomic chemotherapy is often considered for certain types of cancers, and its gentler nature leads to fewer side effects compared to traditional chemotherapy.


How is Metronomic Chemotherapy Given?


Cyclophosphamide, piroxicam, and frusemide are the most common drugs used in metronomic therapy. These are taken orally at home. Before starting metronomic chemotherapy, baseline data is required to assess the malignancy and overall health. Measurements of existing tumors are taken by examination of a visible tumor outside the body, radiography, or ultrasound for internal tumors.

In this video, Dr. André of the well-known E-cancer program explains the benefits of low-dose metronomic chemotherapy.


Metronomic Therapy Side Effects


The most common metronomic chemotherapy side effects may be mild nausea or vomiting, mild to moderate anemia, neutropenia, and some fatigue.


Research on Metronomic Chemotherapy


Metronomic chemotherapy is an effective and low-cost treatment of several types of tumors. Here is some of the latest research: 

> Metronomic Therapy for Breast Cancer

Metronomic administration of oral chemotherapy is a promising treatment strategy for some patients with Metastatic Breast Cancer and inhibits tumor progression via multiple mechanisms of action.

> Head and Neck

Oral metronomic chemotherapy is non-inferior to intravenous cisplatin with respect to overall survival and is associated with fewer adverse events.

A recent Phase 3 study confirmed these conclusions. 

> Ovarian

In summary, based on the clinical responses obtained and the low toxicity of the treatment, metronomic chemotherapy and drug repurposing are options to be taken into account for Ovarian cancer patients.  

  • The treatment with low doses of cyclophosphamide resulted in therapeutic response, ranging from a near clinical complete response to a long stable disease.
  • Metronomic chemotherapy with oral cyclophosphamide presented a low toxicity profile and did not affect the patient’s quality of life.


> Prostate cancer 

A 2022 study looked at nearly 1000 cases of Metastatic castration-resistant prostate cancer, one of the most lethal forms of prostate cancer. The study found low-dose metronomic chemotherapy to be a well-tolerated and cost-effective form of cancer therapy, especially for patients who are older or unfit and who are unable to tolerate conventional mCRPC therapies. 

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