title: Metronomic Chemotherapy for Metastatic Breast Cancer - a Systematic Review of the Literature.
abstract: Conventional chemotherapy is generally administered in high doses followed by a treatment-free period to give the body needful time to recover. This "maximum tolerated dose" approach results in high response rates. However, long periods between therapy cycles can lead to development of resistance mechanisms and consequently disease progression. One of the most interesting alternative strategies is metronomic chemotherapy. This concept relies on the continuous administration of chemotherapy at low doses and aims at targeting endothelial cells in the tumor bed as well. Recently, metronomic chemotherapy has been incorporated into the recommendations issued by the German AGO expert panel (www.ago-online.de). A systematic review of PubMed/Medline, ClinicalTrials.gov, the European Clinical Trials Database (EudraCT) and the Cochrane Database was conducted. In the present review, we discuss the current evidence on metronomic chemotherapy in metastatic breast cancer.
authors.affiliation: Department of Gynecology and Obstetrics, Marienkrankenhaus Hamburg, Hamburg.
authors.forename: M
authors.initials: M
authors.lastname: Banys-Paluchowski
authors.affiliation: Department of Gynecology and Obstetrics, Heidelberg University Hospital, University of Heidelberg, Heidelberg.
authors.forename: F
authors.initials: F
authors.lastname: Schütz
authors.affiliation: Department of Gynecology and Obstetrics, Heinrich-Heine University Düsseldorf, Düsseldorf.
authors.forename: E
authors.initials: E
authors.lastname: Ruckhäberle
authors.affiliation: Department of Gynecology and Obstetrics, Heinrich-Heine University Düsseldorf, Düsseldorf.
authors.forename: N
authors.initials: N
authors.lastname: Krawczyk
authors.affiliation: Department of Gynecology and Obstetrics, Heinrich-Heine University Düsseldorf, Düsseldorf.
authors.forename: T
authors.initials: T
authors.lastname: Fehm
keywords: breast cancer; metronomic chemotherapy; survival; systematic review; toxicity