Marina E Cazzaniga1, Elisabetta Munzone2, Guido Bocci3, Noémia Afonso4, Patricia Gomez5, Sven Langkjer6, Edgar Petru7, Xavier Pivot8, Pedro Sánchez Rovira9, Piotr Wysocki10, Valter Torri11. 1. ASST Monza, Monza, Italy. marina.cazzaniga@asst-monza.it. 2. IEO, European Institute of Oncology IRCCS, Milan, Italy. 3. Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. 4. Centro Hospitalar do Porto, Porto, Portugal. 5. Vall d'Hebron University Hospital, Vall d'Hebron Institute of Oncology, Barcelona, Spain. 6. Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. 7. University of Graz, Graz, Austria. 8. Centre Paul Strauss, Institut Régional du Cancer, Strasbourg, France. 9. Oncology Department, Complejo Hospitalario de Jaen, Jaen, Spain. 10. Jagiellonian University, Medical College Hospital, Cracow, Poland. 11. IRCCS Mario Negri Institute for Pharmacological Research, Milan, Italy.
Abstract
INTRODUCTION: Metronomic chemotherapy (mCHT) is a treatment regimen in which drugs are administered frequently or continuously and that maintains low, prolonged, and pharmacologically active plasma concentrations of drugs to avoid toxicity associated with traditional chemotherapy regimens, while achieving tumor response. Despite the increasing use of mCHT in patients with metastatic breast cancer (MBC) and the endorsement of mCHT in guidelines, no consensus exists about which patients may substantially benefit from mCHT, which agents can be recommended, and in which treatment setting mCHT is most appropriate. METHODS: In October 2017, ten international experts in the management of breast cancer convened to develop a report describing the current status of the use of mCHT for the treatment of advanced breast cancer, based not only on current literature but also on their opinion. The Delphi method was used to reach consensus. RESULTS: A full consensus was reached concerning the acknowledgement that mCHT is not simply a different way of administering chemotherapy but a truly new treatment option. The best-known effect of mCHT is on angiogenesis inhibition, but exciting new data are on the way regarding potential activity on immune system activation. The experts strongly suggest that the ideal patients for mCHT are those with hormone receptor (HR)-positive tumors or those with triple-negative disease. Independently of HR status, mCHT could be an advantageous option for elderly patients, who are often under-treated simply because of their age. CONCLUSION: Current data support the use of mCHT in selected patients with MBC. FUNDING: Pierre Fabre.
INTRODUCTION: Metronomic chemotherapy (mCHT) is a treatment regimen in which drugs are administered frequently or continuously and that maintains low, prolonged, and pharmacologically active plasma concentrations of drugs to avoid toxicity associated with traditional chemotherapy regimens, while achieving tumor response. Despite the increasing use of mCHT in patients with metastatic breast cancer (MBC) and the endorsement of mCHT in guidelines, no consensus exists about which patients may substantially benefit from mCHT, which agents can be recommended, and in which treatment setting mCHT is most appropriate. METHODS: In October 2017, ten international experts in the management of breast cancer convened to develop a report describing the current status of the use of mCHT for the treatment of advanced breast cancer, based not only on current literature but also on their opinion. The Delphi method was used to reach consensus. RESULTS: A full consensus was reached concerning the acknowledgement that mCHT is not simply a different way of administering chemotherapy but a truly new treatment option. The best-known effect of mCHT is on angiogenesis inhibition, but exciting new data are on the way regarding potential activity on immune system activation. The experts strongly suggest that the ideal patients for mCHT are those with hormone receptor (HR)-positive tumors or those with triple-negative disease. Independently of HR status, mCHT could be an advantageous option for elderly patients, who are often under-treated simply because of their age. CONCLUSION: Current data support the use of mCHT in selected patients with MBC. FUNDING: Pierre Fabre.
Entities:
Keywords:
Breast cancer; Consensus meeting; Metronomic chemotherapy; Vinorelbine
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