Potential role of metronomic chemotherapy in the treatment of esophageal and gastroesophageal cancer
Patients with esophagogastric cancer have poor prognoses in spite of the best available therapies. Patients are debilitated and may not tolerate, or may progress, on standard cytotoxic chemotherapy regimens. Metronomic chemotherapy is an attractive treatment option due to its very low reported toxic...
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| Veröffentlicht in: | Cancer letters 2017-08, Vol.400, p.267-275 |
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| creator | Noronha, Vanita, MBBS, MD, DM Patil, Vijay M., MBBS, MD, DM Joshi, Amit, MBBS, MD, DM Chougule, Anuradha, PhD Banavali, Shripad, MBBS, MD Prabhash, Kumar, Dr |
| description | Patients with esophagogastric cancer have poor prognoses in spite of the best available therapies. Patients are debilitated and may not tolerate, or may progress, on standard cytotoxic chemotherapy regimens. Metronomic chemotherapy is an attractive treatment option due to its very low reported toxicity, modest efficacy, low cost and ease of administration. Capecitabine is the most common drug used in metronomic scheduling; other drugs include cyclophosphamide and paclitaxel. Dosing of capecitabine can range from 1000 mg orally daily for 4 weeks on and 1 week off to a continuous dosing schedule of 1500 mg orally daily. Reported toxicities, including neutropenia, mucositis and hand-foot syndrome, occur in < 10% of patients. As there is a lack of well-conducted, randomized clinical trials evaluating the role of metronomic chemotherapy in esophagogastric cancer, it cannot be recommended as the standard of care; however, it can be considered to be a therapeutic option, especially in elderly patients with relapsed disease for whom other therapeutic options are limited. |
| doi_str_mv | 10.1016/j.canlet.2017.01.017 |
| format | Article |
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Patients are debilitated and may not tolerate, or may progress, on standard cytotoxic chemotherapy regimens. Metronomic chemotherapy is an attractive treatment option due to its very low reported toxicity, modest efficacy, low cost and ease of administration. Capecitabine is the most common drug used in metronomic scheduling; other drugs include cyclophosphamide and paclitaxel. Dosing of capecitabine can range from 1000 mg orally daily for 4 weeks on and 1 week off to a continuous dosing schedule of 1500 mg orally daily. Reported toxicities, including neutropenia, mucositis and hand-foot syndrome, occur in < 10% of patients. As there is a lack of well-conducted, randomized clinical trials evaluating the role of metronomic chemotherapy in esophagogastric cancer, it cannot be recommended as the standard of care; however, it can be considered to be a therapeutic option, especially in elderly patients with relapsed disease for whom other therapeutic options are limited.</description><identifier>ISSN: 0304-3835</identifier><identifier>EISSN: 1872-7980</identifier><identifier>DOI: 10.1016/j.canlet.2017.01.017</identifier><identifier>PMID: 28109908</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>5-Fluorouracil ; Administration, Metronomic ; Angiogenesis ; Antiangiogenic agents ; Antineoplastic Agents - administration & dosage ; Antineoplastic Agents - adverse effects ; Antitumor agents ; Brachytherapy ; Brain ; Brain cancer ; Brain tumors ; Breast cancer ; Cancer therapies ; Capecitabine - administration & dosage ; Chemotherapy ; Clinical trials ; Colorectal cancer ; Colorectal carcinoma ; Cyclophosphamide - administration & dosage ; Cytotoxicity ; Dormancy ; Drug dosages ; Drug resistance ; Esophageal cancer ; Esophageal Neoplasms - drug therapy ; Esophageal Neoplasms - pathology ; Esophagogastric ; Esophagus ; Evidence-Based Medicine ; Fractionation ; Gastric ; Gastric cancer ; Hematology, Oncology and Palliative Medicine ; Humans ; Immune response ; Immunotherapy ; Intestine ; Leukemia ; Liver ; Lung cancer ; Lymphoma ; Malignancy ; Medical prognosis ; Medical research ; Melanoma ; Metastases ; Metronomic ; Mice ; Paclitaxel - administration & dosage ; Patient Selection ; Patients ; Peritoneum ; Platinum ; Prognosis ; Promotion ; Radiation ; Radiation therapy ; Repurposing ; Scheduling ; Stomach Neoplasms - drug therapy ; Stomach Neoplasms - pathology ; Surgery ; Toxicity ; Treatment Outcome ; Tumor cells ; Tumors ; Vascular endothelial growth factor</subject><ispartof>Cancer letters, 2017-08, Vol.400, p.267-275</ispartof><rights>2017</rights><rights>Copyright © 2017. 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Patients are debilitated and may not tolerate, or may progress, on standard cytotoxic chemotherapy regimens. Metronomic chemotherapy is an attractive treatment option due to its very low reported toxicity, modest efficacy, low cost and ease of administration. Capecitabine is the most common drug used in metronomic scheduling; other drugs include cyclophosphamide and paclitaxel. Dosing of capecitabine can range from 1000 mg orally daily for 4 weeks on and 1 week off to a continuous dosing schedule of 1500 mg orally daily. Reported toxicities, including neutropenia, mucositis and hand-foot syndrome, occur in < 10% of patients. As there is a lack of well-conducted, randomized clinical trials evaluating the role of metronomic chemotherapy in esophagogastric cancer, it cannot be recommended as the standard of care; however, it can be considered to be a therapeutic option, especially in elderly patients with relapsed disease for whom other therapeutic options are limited.</description><subject>5-Fluorouracil</subject><subject>Administration, Metronomic</subject><subject>Angiogenesis</subject><subject>Antiangiogenic agents</subject><subject>Antineoplastic Agents - administration & dosage</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>Antitumor agents</subject><subject>Brachytherapy</subject><subject>Brain</subject><subject>Brain cancer</subject><subject>Brain tumors</subject><subject>Breast cancer</subject><subject>Cancer therapies</subject><subject>Capecitabine - administration & dosage</subject><subject>Chemotherapy</subject><subject>Clinical trials</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Cyclophosphamide - administration & dosage</subject><subject>Cytotoxicity</subject><subject>Dormancy</subject><subject>Drug dosages</subject><subject>Drug resistance</subject><subject>Esophageal cancer</subject><subject>Esophageal Neoplasms - drug therapy</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophagogastric</subject><subject>Esophagus</subject><subject>Evidence-Based Medicine</subject><subject>Fractionation</subject><subject>Gastric</subject><subject>Gastric cancer</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Immune response</subject><subject>Immunotherapy</subject><subject>Intestine</subject><subject>Leukemia</subject><subject>Liver</subject><subject>Lung cancer</subject><subject>Lymphoma</subject><subject>Malignancy</subject><subject>Medical prognosis</subject><subject>Medical research</subject><subject>Melanoma</subject><subject>Metastases</subject><subject>Metronomic</subject><subject>Mice</subject><subject>Paclitaxel - administration & dosage</subject><subject>Patient Selection</subject><subject>Patients</subject><subject>Peritoneum</subject><subject>Platinum</subject><subject>Prognosis</subject><subject>Promotion</subject><subject>Radiation</subject><subject>Radiation therapy</subject><subject>Repurposing</subject><subject>Scheduling</subject><subject>Stomach Neoplasms - drug therapy</subject><subject>Stomach Neoplasms - pathology</subject><subject>Surgery</subject><subject>Toxicity</subject><subject>Treatment Outcome</subject><subject>Tumor cells</subject><subject>Tumors</subject><subject>Vascular endothelial growth factor</subject><issn>0304-3835</issn><issn>1872-7980</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUV1rGzEQFCWldtP-gxAO8nzu6qTznV4CwaRtwNBCG8ibkHV7tpy7kyPJAf_77uF8kZfCIgkxM7szy9gZhxkHPv-2nVkzdJhmBfBqBpyq-sCmvK6KvFI1nLApCJC5qEU5YZ9j3AJAKavyE5sUNQeloJ6y5rdPOCRnuiz4DjPfZj2m4AffO5vZDfY-bTCY3SFzQ0bPLAU0qSfOiMXodxuzRqKbocnWJhL3zSeNaDF8YR9b00X8-nSfstvv138XP_Plrx83i6tlbqUsU84FcAtSWlAFCDFvSzoVzS9rY2yDHKt2Be2qKJuam7aV9dysGlOB5MoQUJyyi6PuLviHPcakt34fBmqpuYJCKiUACCWPKBt8jAFbvQuuN-GgOegxWr3Vx2j1GK0GTlUR7fxJfL_qsXkhPWdJgMsjAMnio8Ogo3VI_hsX0CbdePe_Du8FbOcGZ013jweMr150LDToP-N6x-0SFUDCnfgH1yOhmQ</recordid><startdate>20170801</startdate><enddate>20170801</enddate><creator>Noronha, Vanita, MBBS, MD, DM</creator><creator>Patil, Vijay M., MBBS, MD, DM</creator><creator>Joshi, Amit, MBBS, MD, DM</creator><creator>Chougule, Anuradha, PhD</creator><creator>Banavali, Shripad, MBBS, MD</creator><creator>Prabhash, Kumar, Dr</creator><general>Elsevier B.V</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><orcidid>https://orcid.org/0000-0001-8858-5004</orcidid></search><sort><creationdate>20170801</creationdate><title>Potential role of metronomic chemotherapy in the treatment of esophageal and gastroesophageal cancer</title><author>Noronha, Vanita, MBBS, MD, DM ; Patil, Vijay M., MBBS, MD, DM ; Joshi, Amit, MBBS, MD, DM ; Chougule, Anuradha, PhD ; Banavali, Shripad, MBBS, MD ; Prabhash, Kumar, Dr</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c445t-1301c044c0920336f5033938348aacde1e7fb0fb25d81aff486abda70419a3933</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>5-Fluorouracil</topic><topic>Administration, Metronomic</topic><topic>Angiogenesis</topic><topic>Antiangiogenic agents</topic><topic>Antineoplastic Agents - administration & dosage</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>Antitumor agents</topic><topic>Brachytherapy</topic><topic>Brain</topic><topic>Brain cancer</topic><topic>Brain tumors</topic><topic>Breast cancer</topic><topic>Cancer therapies</topic><topic>Capecitabine - administration & dosage</topic><topic>Chemotherapy</topic><topic>Clinical trials</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Cyclophosphamide - administration & dosage</topic><topic>Cytotoxicity</topic><topic>Dormancy</topic><topic>Drug dosages</topic><topic>Drug resistance</topic><topic>Esophageal cancer</topic><topic>Esophageal Neoplasms - drug therapy</topic><topic>Esophageal Neoplasms - pathology</topic><topic>Esophagogastric</topic><topic>Esophagus</topic><topic>Evidence-Based Medicine</topic><topic>Fractionation</topic><topic>Gastric</topic><topic>Gastric cancer</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Immune response</topic><topic>Immunotherapy</topic><topic>Intestine</topic><topic>Leukemia</topic><topic>Liver</topic><topic>Lung cancer</topic><topic>Lymphoma</topic><topic>Malignancy</topic><topic>Medical prognosis</topic><topic>Medical research</topic><topic>Melanoma</topic><topic>Metastases</topic><topic>Metronomic</topic><topic>Mice</topic><topic>Paclitaxel - administration & dosage</topic><topic>Patient Selection</topic><topic>Patients</topic><topic>Peritoneum</topic><topic>Platinum</topic><topic>Prognosis</topic><topic>Promotion</topic><topic>Radiation</topic><topic>Radiation therapy</topic><topic>Repurposing</topic><topic>Scheduling</topic><topic>Stomach Neoplasms - drug therapy</topic><topic>Stomach Neoplasms - pathology</topic><topic>Surgery</topic><topic>Toxicity</topic><topic>Treatment Outcome</topic><topic>Tumor cells</topic><topic>Tumors</topic><topic>Vascular endothelial growth factor</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Noronha, Vanita, MBBS, MD, DM</creatorcontrib><creatorcontrib>Patil, Vijay M., MBBS, MD, DM</creatorcontrib><creatorcontrib>Joshi, Amit, MBBS, MD, DM</creatorcontrib><creatorcontrib>Chougule, Anuradha, PhD</creatorcontrib><creatorcontrib>Banavali, Shripad, MBBS, MD</creatorcontrib><creatorcontrib>Prabhash, Kumar, Dr</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Cancer letters</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Noronha, Vanita, MBBS, MD, DM</au><au>Patil, Vijay M., MBBS, MD, DM</au><au>Joshi, Amit, MBBS, MD, DM</au><au>Chougule, Anuradha, PhD</au><au>Banavali, Shripad, MBBS, MD</au><au>Prabhash, Kumar, Dr</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Potential role of metronomic chemotherapy in the treatment of esophageal and gastroesophageal cancer</atitle><jtitle>Cancer letters</jtitle><addtitle>Cancer Lett</addtitle><date>2017-08-01</date><risdate>2017</risdate><volume>400</volume><spage>267</spage><epage>275</epage><pages>267-275</pages><issn>0304-3835</issn><eissn>1872-7980</eissn><abstract>Patients with esophagogastric cancer have poor prognoses in spite of the best available therapies. Patients are debilitated and may not tolerate, or may progress, on standard cytotoxic chemotherapy regimens. Metronomic chemotherapy is an attractive treatment option due to its very low reported toxicity, modest efficacy, low cost and ease of administration. Capecitabine is the most common drug used in metronomic scheduling; other drugs include cyclophosphamide and paclitaxel. Dosing of capecitabine can range from 1000 mg orally daily for 4 weeks on and 1 week off to a continuous dosing schedule of 1500 mg orally daily. Reported toxicities, including neutropenia, mucositis and hand-foot syndrome, occur in < 10% of patients. As there is a lack of well-conducted, randomized clinical trials evaluating the role of metronomic chemotherapy in esophagogastric cancer, it cannot be recommended as the standard of care; however, it can be considered to be a therapeutic option, especially in elderly patients with relapsed disease for whom other therapeutic options are limited.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>28109908</pmid><doi>10.1016/j.canlet.2017.01.017</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8858-5004</orcidid></addata></record> |
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| ispartof | Cancer letters, 2017-08, Vol.400, p.267-275 |
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| subjects | 5-Fluorouracil Administration, Metronomic Angiogenesis Antiangiogenic agents Antineoplastic Agents - administration & dosage Antineoplastic Agents - adverse effects Antitumor agents Brachytherapy Brain Brain cancer Brain tumors Breast cancer Cancer therapies Capecitabine - administration & dosage Chemotherapy Clinical trials Colorectal cancer Colorectal carcinoma Cyclophosphamide - administration & dosage Cytotoxicity Dormancy Drug dosages Drug resistance Esophageal cancer Esophageal Neoplasms - drug therapy Esophageal Neoplasms - pathology Esophagogastric Esophagus Evidence-Based Medicine Fractionation Gastric Gastric cancer Hematology, Oncology and Palliative Medicine Humans Immune response Immunotherapy Intestine Leukemia Liver Lung cancer Lymphoma Malignancy Medical prognosis Medical research Melanoma Metastases Metronomic Mice Paclitaxel - administration & dosage Patient Selection Patients Peritoneum Platinum Prognosis Promotion Radiation Radiation therapy Repurposing Scheduling Stomach Neoplasms - drug therapy Stomach Neoplasms - pathology Surgery Toxicity Treatment Outcome Tumor cells Tumors Vascular endothelial growth factor |
| title | Potential role of metronomic chemotherapy in the treatment of esophageal and gastroesophageal cancer |
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