title: Tackling pancreatic cancer with metronomic chemotherapy.
abstract: Pancreatic tumours, the majority of which arise from the exocrine pancreas, have recently shown an increasing incidence in western countries. Over the past few years more and more new selective molecules directed against specific cellular targets have become available for cancer therapy, leading to significant improvements. However, despite such advances in therapy, prognosis of pancreatic cancer remains disappointing. Metronomic chemotherapy (MCT), which consists in the administration of continuous, low-dose anticancer drugs, has demonstrated the ability to suppress tumour growth. Thus, it may provide an additional therapeutic opportunity for counteracting the progression of the tumour. Here we discuss evidence arising from preclinical and clinical studies regarding the use of MCT in pancreatic cancer. Good results have generally been achieved in preclinical studies, particularly when MCT was combined with standard dose chemotherapy or antinflammatory, antiangiogenic and immunostimolatory agents. The few available clinical experiences, which mainly refer to retrospective data, have reported good tolerability though mild activity of metronomic schedules. Further studies are therefore awaited to confirm both preclinical findings and the preliminary clinical data.
authors.affiliation: Sapienza University, Sant'Andrea Hospital, Medical Oncology Unit, Via di Grottarossa 1035-1039, 00189, Rome, Italy. Electronic address: adriana.romiti@uniroma1.it.
authors.forename: Adriana
authors.initials: A
authors.lastname: Romiti
authors.affiliation: Sapienza University, Sant'Andrea Hospital, Medical Oncology Unit, Via di Grottarossa 1035-1039, 00189, Rome, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Falcone
authors.affiliation: Sapienza University, Sant'Andrea Hospital, Medical Oncology Unit, Via di Grottarossa 1035-1039, 00189, Rome, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Roberto
authors.affiliation: Sapienza University, Sant'Andrea Hospital, Medical Oncology Unit, Via di Grottarossa 1035-1039, 00189, Rome, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Marchetti
mesh_terms: D059250:Administration, Metronomic; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D017209:Apoptosis / Q000187:drug effects; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D002465:Cell Movement / Q000187:drug effects; D049109:Cell Proliferation / Q000187:drug effects; D006801:Humans; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome; D047368:Tumor Burden / Q000187:drug effects; D059016:Tumor Microenvironment
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor
keywords: Low-dose chemotherapy; Metronomic chemotherapy; Pancreatic adenocarcinoma; Pancreatic cancer; Therapeutic efficacy