Selected current data on metronomic therapy (and its promise) from India

Abstract

We refer to data on metronomic therapy from India and selected other abstracts mentioned below while discussing its current value and future promise. METRONOMIC THERAPY IN HEAD AND NECK CANCER An audit of the results of a triplet metronomic chemotherapy regimen incorporating a tyrosine kinase inhibitor in recurrent/metastatic head and neck cancers patients

Widely disseminated metastatic Ewing sarcoma: Sustained, complete metabolic response to first‐line oral metronomic chemotherapy

“…In addition to the antiestrogenic action, tamoxifen has antiangiogenic action ,mediated by several mechanisms, vascular endothelial growth factor among them 14‐16 . Hence, it is used as part of the OMCT protocol for ES in our institute 10,11 . The patient reported symptomatic relief at the first follow‐up with good tolerance.…”

“…In a cohort of 46 heavily pretreated ES, Podda et al described a response rate of 24% with oral Eto 9 . With the protocol we used, a response rate of 59% with progression‐free survival of 12.5 months was demonstrated in relapsed/metastatic ES 10,11 . A small randomized trial of OMCT in progressive solid tumors failed to show benefit, however, so there were concerns about true metronomic nature of the protocol 12,19 …”

“…It induces tumor dormancy by antiangiogenic and immunomodulatory activities 7,8 . OMCT, though not a standard treatment option, has been reported to have varying responses in metastatic ES 9‐13 …”

Metronomic Chemotherapy: Role in Developing Countries for Head and Neck Cancer

“…The hazard ratio was 0.58 in favour of cetuximab cohort (P = 0.031). [15] However, cetuximab, being a significantly more expensive therapy, may not be feasible routinely in low-and middle-resource countries such as India and Pakistan. Complete remission was seen in two patients, partial remission in seven patients, stable disease in four patients, and progressive disease in two patients in a single-arm prospective observational study of 15 patients who received MC in the form of oral methotrexate (15 mg/m 2 /week), oral celecoxib (200 mg twice daily) and erlotinib (150 mg once daily).…”

Next generation metronomic chemotherapy—report from the Fifth Biennial International Metronomic and Anti-angiogenic Therapy Meeting, 6–8 May 2016, Mumbai

“…Hitesh Khatwani reported on oral MC in metastatic triple negative breast cancer [119]. Vanita Noronha discussed a prospective randomised Phase II study comparing MC versus single agent cisplatin in patients with metastatic, relapsed or inoperable squamous cell carcinoma of the head and neck [102].…”