Metronomic chemotherapy: principles and lessons learned from applications in the treatment of metastatic prostate cancer.
By frequent and protracted administration of conventional cytotoxic drugs without prolonged interruptions, the primary treatment target shifts from the tumor cell population to the tumor vasculature. This "metronomic" way of chemotherapy administration results in antivascular effects, the mechanistic basis of which remains to be fully elucidated. We outline the basic aspects of the metronomic concept, describe the results of clinical applications of such chemotherapy by focusing on studies in metastatic prostate cancer, and discuss certain shortcomings. Based on preclinical findings, we finally point to the possible ways to address these shortcomings in order to bring this novel and promising use of conventional anticancer agents to full fruition.
Emmenegger
Urban
U
Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075, Bayview Avenue, Toronto, ON, Canada, M4N3M5. urban.emmenegger@sri.utoronto.ca
Francia
Giulio
G
Shaked
Yuval
Y
Kerbel
Robert S
RS
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D042783:Endothelial Cells / Q000502:physiology; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D013234:Stem Cells / Q000502:physiology
D020533:Angiogenesis Inhibitors