Metronomic Chemotherapy in Cancer Treatment

Dear Colleague,

Despite profound progress in cancer treatment and the development of many novel molecularly targeted agents, chemotherapy remains the backbone and most often used form of systemic therapy for oncological malignancies. With the advent of targeted chemotherapy, which is based on antibody–drug conjugates, there is discussion regarding if and for how long classical chemotherapy will remain in the armamentarium of medical oncologists. Nevertheless, classical chemotherapy is still routinely used in both curative and palliative settings, but the way oncologists use this therapeutic tool has significantly evolved over the last decades. One essential step toward improving the safety and efficacy of chemotherapy, especially when administered in a palliative, long-term setting, is to administer cytotoxic drugs in a metronomic fashion. Metronomic chemotherapy represents a unique chemotherapeutic treatment modality that utilizes single- or multi-agent regimens, administered in short or ultra-short intervals. This strategy, owing to its excellent safety profile and multidirectional antitumor activity (inhibiting tumor cell proliferation, suppressing tumor-induced angiogenesis, and reversing immunosuppression) represents a unique but broadly unappreciated systemic treatment strategy. Moreover, metronomic chemotherapy may represent a unique therapeutic partner for many targeted agents (kinase inhibitors, immune checkpoint inhibitors, endocrine agents), and this concept is being evaluated in many recently initiated clinical studies. The focus of this Special Issue is includes the following: (a) describe the mechanisms of the action of metronomic chemotherapy; (b) present the potential of metronomic chemotherapy in the treatment of various cancers; (c) discuss the role of metronomic chemotherapy as a partner for novel strategies, combining it with molecularly targeted agents and immunotherapies; (d) underscore the role of metronomic chemotherapy in low- and middle-income countries, where, in many cases, it may offer an alternative to the novel, financially unavailable cancer treatments.

Dr. Piotr J. Wysocki
Guest Editor

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• metronomic chemotherapy
• solid tumors
• breast cancer
• gynecological cancer
• genitourinary cancers
• gastrointestinal cancers
• lung cancer
• combined cancer treatment