Metronomic chemotherapy for patients with metastatic breast cancer: Review of effectiveness and potential use during pandemics

Fares, Johny; Tomb, Paul El; Khalil, Lana; Atwani, Rula W.; Moukadem, Hiba; Awada, Ahmad; Saghir, Nagi S. El

doi:10.1016/j.ctrv.2020.102066

Cited by 20 publications

(15 citation statements)

References 49 publications

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“…Although the sample size is limited, this study demonstrated promising efficacy of mNH regimen in HER2-positive MBC patients. The concept of "dose intensity" is the foundation of conventional chemotherapy [16]. In the conventional chemotherapy, chemotherapeutic drugs are delivered at the highest tolerable dose in cycles with 3-4 weeks interval.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy study of oral metronomic vinorelbine combined with trastuzumab (mNH) in HER2-positive metastatic breast cancer: a phase II trial

Wang

Liu

et al. 2021

Breast Cancer Res Treat

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy study of oral metronomic vinorelbine combined with trastuzumab (mNH) in HER2-positive metastatic breast cancer: a phase II trial

Wang

Liu

et al. 2021

Breast Cancer Res Treat

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“…For many decades, cytotoxic chemotherapeutics are still the cornerstone of BC treatment ( 134 ). However, encouraging advancements in cancer immunotherapy have provided more options for certain subtypes of BC ( 11 , 135 ).…”

Section: Discussionmentioning

confidence: 99%

Immunostimulatory Properties of Chemotherapy in Breast Cancer: From Immunogenic Modulation Mechanisms to Clinical Practice

et al. 2022

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Breast cancer (BC) is the most common malignancy among females. Chemotherapy drugs remain the cornerstone of treatment of BC and undergo significant shifts over the past 100 years. The advent of immunotherapy presents promising opportunities and constitutes a significant complementary to existing therapeutic strategies for BC. Chemotherapy as a cytotoxic treatment that targets proliferation malignant cells has recently been shown as an effective immune-stimulus in multiple ways. Chemotherapeutic drugs can cause the release of damage-associated molecular patterns (DAMPs) from dying tumor cells, which result in long-lasting antitumor immunity by the key process of immunogenic cell death (ICD). Furthermore, Off-target effects of chemotherapy on immune cell subsets mainly involve activation of immune effector cells including natural killer (NK) cells, dendritic cells (DCs), and cytotoxic T cells, and depletion of immunosuppressive cells including Treg cells, M2 macrophages and myeloid-derived suppressor cells (MDSCs). Current mini-review summarized recent large clinical trials regarding the combination of chemotherapy and immunotherapy in BC and addressed the molecular mechanisms of immunostimulatory properties of chemotherapy in BC. The purpose of our work was to explore the immune-stimulating effects of chemotherapy at the molecular level based on the evidence from clinical trials, which might be a rationale for combinations of chemotherapy and immunotherapy in BC.

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“…[ 28 , 29 ] MC does not rely on powerful killing effect but inhibits tumor by influencing multiple mechanisms such as apoptosis, senescence, non-apoptotic cell death and immunogenic cell death, anti-angiogenesis and immune regulation, and is less likely to develop drug resistance. [ 30 , 31 ] This may be why MC works better than conventional chemotherapy. Based on low dose, MC induces less toxicity and is Easier to tolerate with, leading to better quality of life.…”

Section: Discussionmentioning

confidence: 99%

Comparative efficacy and safety of metronomic chemotherapy in breast cancer

Xie

Chen

et al. 2021

Medicine

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Background: Metronomic chemotherapy (MC) strategy has been used in breast cancer for more than a decade since it was first proposed. The purpose of this study is to systematically evaluate its efficacy and safety for breast cancer patients at various stages, as well as to clarify the most effective medication strategy when applying MC and discover its most sensitive subpopulation in breast cancer patients. Method: We will systematically retrieve random controlled trials evaluating the efficacy and safety of MC in breast cancer on PubMed, Cochrane Library, Embase, and web of science to perform this network meta-analysis. Markov chain Monte Carlo method based on Bayesian Theory will be used to conduct network meta-analysis and the efficacy and safety will be ranked by combining direct and indirect evidence in mixed treatment comparisons. We will assess the quality of literatures with the Cochrane Risk Bias Assessment Tool and assess the strength of the evidence using the GRADE methodology. Data analysis will be completed with the WinBUGS, R, Stata and RevMan softwares. Results and conclusion: Through the analysis, we can obtain the ranking of efficacy and safety in different MC strategy, and reveal the specific breast cancer groups that are more sensitive to MC. We access the effectiveness by disease free survival, progress free survival, time to progress, objective response rate, and overall survival, and measure the toxicity by dose-limiting toxicity. The result of our study could provide evidence for clinicians to make a better choice when they consider MC. Inplasy registration number: INPLASY202140142.

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Metronomic chemotherapy for patients with metastatic breast cancer: Review of effectiveness and potential use during pandemics

Cited by 20 publications

References 49 publications

Safety and efficacy study of oral metronomic vinorelbine combined with trastuzumab (mNH) in HER2-positive metastatic breast cancer: a phase II trial

Safety and efficacy study of oral metronomic vinorelbine combined with trastuzumab (mNH) in HER2-positive metastatic breast cancer: a phase II trial

Immunostimulatory Properties of Chemotherapy in Breast Cancer: From Immunogenic Modulation Mechanisms to Clinical Practice

Comparative efficacy and safety of metronomic chemotherapy in breast cancer

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