Metronomic chemotherapy: Low-dose chemotherapy for advanced cancers

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Metronomic chemotherapy: Low-dose chemotherapy for advanced cancers

Metronomic chemotherapy for cancer treatment — Get the latest on this area of cancer research.

It seems contrary to current cancer therapy, but cancer researchers are investigating whether smaller doses of chemotherapy drugs could be more effective in certain situations. Researchers call it metronomic chemotherapy, referring to the steady schedule of chemotherapy doses. And they're finding that in the case of some people with advanced cancers or cancer that has become resistant to chemotherapy, less may be more successful.

Traditional chemotherapy treatment delivers the highest doses possible to kill cancer cells. Along with large doses come significant side effects. Metronomic chemotherapy aims to lessen the side effects of treatment while rendering cancer cells inactive. Researchers hope metronomic chemotherapy will one day make cancer a manageable chronic condition.

What is metronomic chemotherapy?

Metronomic chemotherapy uses traditional chemotherapy drugs in a new way. Rather than receiving the largest dose of chemotherapy possible, people undergoing metronomic chemotherapy receive as little as one-tenth the normal dose. Smaller doses are less damaging to healthy cells in the body, so chemotherapy can be administered more frequently — sometimes every day.

People undergoing traditional chemotherapy treatment usually wait weeks between treatments to let their healthy cells recover. For instance, you may need to wait until your blood counts are restored to acceptable levels before you can receive your next chemo treatment. Unfortunately this interval between treatments also allows the cells that help supply oxygen and nutrients to a tumor (endothelial cells) time to heal and regenerate so they can revive the cancer cells.

Metronomic chemotherapy targets the tumor's endothelial cells, rather than the cancer cells. Endothelial cells are found in the tumor's blood vessels. By killing the endothelial cells, the blood supply is cut off. Without a blood supply, cancer cells may die or the tumor may shrink. Tumors without blood supplies remain very small — usually less than 3 millimeters.

A drug that alters the blood supply to a tumor is called an angiogenesis inhibitor. Angiogenesis refers to the process of growing blood vessels. Metronomic chemotherapy is sometimes called anti-angiogenic chemotherapy.

  Traditional chemotherapy Metronomic chemotherapy
Dose Highest possible dose One-tenth to one-third of the traditional dose
Wait between doses Weeks Days
Cells targeted Cancer cells Endothelial cells that provide nutrients to tumor
Goal of treatment Kill cancer cells Stop endothelial cells from supporting the cancer cells
Most useful for Adjuvant therapy for people with early-stage cancers, or certain rapidly growing chemotherapy-sensitive tumors Large tumors that can't be removed through surgery, or cancer that has spread

Last Updated: 04/26/2006
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