The journal «Practical oncology» / Т. 20, №4, 2019, Перспективные мишени в лечении злокачественных опухолей

Metronomic chemotherapy: efficacy in real clinical practice



One of the strategies to overcome the resistance to modern drug treatment is the metronomic therapy of the malignant tumors. This is a chronic continuous administration of low doses of the drugs in order to influence both tumor cells and their microenvironment in order to change the natural history of the growth of the malignant tumors and increase the overall survival. The aim was to study the effectiveness of the metronomic regimen of cyclophosphamide and methotrexate in patients with various malignant tumors.

Materials and methods. The experience of the metronomic chemotherapy with cyclophosphamide and methotrexate over 3,5 years in the Oncology Center is analyzed. Of the 678 patients, the vast majority (377) were patients of the older age group. 343 patients were in a poor condition (ECOG 2-4). MT was prescribed in various lines of the treatment, but mainly, after the development of resistance to the standard treatment (from the 2nd and more). The diagnosis were extremely
heterogeneous (colon cancer – 103, breast cancer – 84, head and neck tumors – 80, lung cancer – 78 and primary multiple tumors – 72). Number of metastatic sites were 2 and more organs. Adenocarcinoma and squamous cell carcinoma were more often.

Results. The objective response was 8,1%. Stable disease was 68,9%. Progressive disease was reported in 23% of cases. The median time to progression was 7 months. The metronomic therapy regimen was well tolerated and had no any clinically significant toxicity.

Conclusions. The work demonstrates the clinical effectiveness of the metronomic regimen of cyclophosphamide and
methotrexate in various malignant neoplasms.