Metronomic therapy

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Angiogenesis medical animation still
Mechanisms of suppression by regulatory T cells

Metronomic therapy is a form of chemotherapy treatment that involves the frequent, regular administration of drugs at doses significantly lower than the maximum tolerated doses (MTD). Unlike traditional chemotherapy, which often involves high-dose treatments followed by rest periods, metronomic therapy aims to minimize side effects and maintain a steady pressure on cancer cells to prevent angiogenesis, the process by which tumors develop their own blood supply to fuel their growth.

Overview[edit | edit source]

The concept of metronomic therapy emerged from the observation that lower, more frequent doses of chemotherapy drugs could exert anti-tumor effects by targeting the endothelial cells in the tumor's vasculature. This approach contrasts with the conventional use of chemotherapy, which targets the rapidly dividing cancer cells but also affects rapidly dividing normal cells, leading to significant toxicity.

Mechanism of Action[edit | edit source]

Metronomic therapy works through multiple mechanisms. One of the primary mechanisms is the inhibition of angiogenesis. By continuously exposing endothelial cells to chemotherapy drugs, metronomic therapy can prevent the formation of new blood vessels that tumors need to grow. Additionally, this therapy modality can stimulate the immune system to recognize and attack cancer cells and may reduce the potential for cancer drug resistance by maintaining constant drug pressure on the tumor.

Advantages[edit | edit source]

The advantages of metronomic therapy include reduced side effects, improved quality of life for patients, and the potential for long-term administration due to its lower toxicity profile. It is particularly beneficial for patients who cannot tolerate the high doses of standard chemotherapy or for those with cancers that have become resistant to traditional treatments.

Clinical Applications[edit | edit source]

Metronomic therapy has been explored in various types of cancer, including breast cancer, prostate cancer, and glioblastoma. It is often used in combination with other therapies, such as targeted therapy and immunotherapy, to enhance its anti-tumor effects.

Challenges and Limitations[edit | edit source]

Despite its potential benefits, metronomic therapy faces several challenges. Determining the optimal dosing schedule and combination with other treatments requires further research. Additionally, the long-term effects and efficacy of this treatment approach in comparison to traditional chemotherapy regimens are still under investigation.

Conclusion[edit | edit source]

Metronomic therapy represents a promising shift in the paradigm of cancer treatment, focusing on lower, more frequent doses of chemotherapy to reduce toxicity and target the tumor microenvironment. As research continues, this approach may offer a viable alternative for patients seeking less aggressive treatment options.

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Contributors: Prab R. Tumpati, MD