Low-dose metronomic chemotherapy: a systematic literature analysis
K Lien1, S Georgsdottir, L Sivanathan
1Division of Medical Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada.
European Journal of Cancer (Oxford, England : 1990)
|July 25, 2013
Summary
Low-dose metronomic (LDM) chemotherapy offers a safe and effective alternative for various cancers, showing promising tumor control. However, this systematic review found no clear predictors for treatment response in patients receiving LDM therapy.
Area of Science:
- Oncology
- Clinical Pharmacology
- Evidence-Based Medicine
Background:
- Low-dose metronomic (LDM) chemotherapy is an emerging treatment strategy using frequent, low doses of conventional chemotherapeutics.
- While LDM chemotherapy shows potential for tumor control and safety, definitive Phase III trial data and standardized treatment protocols are lacking.
Purpose of the Study:
- To systematically review existing literature on LDM chemotherapy trials.
- To evaluate factors influencing disease control rate (DCR) in patients undergoing LDM therapy.
Main Methods:
- A systematic search of MEDLINE, EMBASE, CENTRAL, and PubMed databases was conducted for fully published LDM chemotherapy trials.
- Meta-regression analysis was used to examine associations between relative dose-intensity (RDI), dosing-density (DD), and DCR.
- Data from 80 retrieved studies, primarily involving breast and prostate cancers, were analyzed.
Main Results:
- The review included 80 studies, predominantly featuring pretreated patients with advanced/metastatic breast and prostate cancers.
- Mean response rate (RR) was 26.03%, median progression-free survival (PFS) was 4.6 months, and mean disease control rate (DCR) was 56.3%.
- No significant association was found between RDI, DD, or specific metronomic drugs and DCR. Grade 3/4 adverse events, such as anemia and fatigue, were infrequent.
Conclusions:
- LDM chemotherapy demonstrates clinical benefit and a favorable safety profile across a range of tumor types.
- Current meta-regression analysis did not identify specific predictive factors for treatment response in LDM therapy.
- Further research is needed to optimize patient selection and treatment parameters for LDM chemotherapy.
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