title: Metronomic therapy and breast cancer: a systematic review.
abstract: Metronomic therapy (MT) refers to repetitive, low doses of chemotherapy drugs. MT exerts an effect not only on tumour cells, but also on their microenvironment. In particular, the low-dose schedule compromises the repairing process of endothelial cells, leading to an anti-angiogenic effect. In addition to the anti-angiogenic effect, MT could have an immunological action through the restoration of the anticancer effect of the immune system and induction of tumour dormancy. Consequently the association of targeted therapy with anti-angiogenic properties or specific immunologic drugs could enhance the efficacy of MT. During the past 15 years, several studies have been published evaluating the metronomic strategy in breast cancer. We conducted a systematic review of the results of phase I, II and III studies testing MT in breast cancer patients. The analyses included the efficacy and toxicity data of MT, and the future development of this strategy in breast cancer are also discussed. The systematic review presented here suggests that MT is a treatment option for breast cancer patients, has a low toxicity profile, efficacy in most patients and has potentially significant cost-effective advantages for public health.
authors.affiliation: Division of Medical Senology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. Electronic address: emilia.montagna@ieo.it.
authors.forename: Emilia
authors.initials: E
authors.lastname: Montagna
authors.affiliation: Division of Medical Senology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cancello
authors.affiliation: Division of Medical Senology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Dellapasqua
authors.affiliation: Division of Medical Senology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Munzone
authors.affiliation: Division of Medical Senology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Colleoni
mesh_terms: D059250:Administration, Metronomic; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000188:drug therapy*; D005260:Female; D006801:Humans
chemical_list: D000970:Antineoplastic Agents
keywords: Breast cancer; Chemotherapy; Metronomic