Metronomic Chemotherapy in Prostate Cancer

Area of Science:

• Oncology
• Pharmacology

Background:

• Metastatic castration-resistant prostate cancer (mCRPC) remains a significant cause of mortality despite numerous therapeutic advancements.
• Novel therapies have expanded treatment options, but disease progression persists, necessitating exploration of alternative strategies.
• Metronomic chemotherapy (MC), a continuous low-dose administration of cytotoxic agents, presents unique multidimensional anti-cancer mechanisms.

Purpose of the Study:

• To investigate the efficacy of metronomic chemotherapy (MC) in heavily pretreated metastatic castration-resistant prostate cancer (mCRPC) patients.
• To identify an optimal MC regimen for future phase II studies in advanced prostate cancer.
• To assess the feasibility and potential of MC in a contemporary mCRPC population.

Main Methods:

• A prospective analysis of consecutive mCRPC patients who had exhausted standard treatment options.
• Evaluation of various metronomic chemotherapy regimens.
• Selection of a preferred MC regimen based on preliminary data for a planned phase II trial.

Main Results:

• The metronomic combination of weekly paclitaxel (60 mg/m2 IV) with capecitabine (1500 mg/d PO) and cyclophosphamide (50 mg/d PO) was identified as a promising regimen.
• This regimen was selected as the preferred option for further investigation in phase II studies.
• The study aimed to establish an effective MC strategy for patients with advanced, treatment-resistant prostate cancer.

Conclusions:

• Metronomic chemotherapy (MC) offers a potential therapeutic avenue for advanced prostate cancer, particularly in heavily pretreated mCRPC patients.
• The selected MC combination warrants further evaluation in a phase II study to determine its clinical activity and safety.
• MC's multidimensional mechanisms, including anti-angiogenesis and immune modulation, make it a compelling strategy for overcoming treatment resistance in mCRPC.