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Clinical Activity of Metronomic Chemotherapy in Liver Cancers

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Metronomic Chemotherapy

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Abstract

Treating advanced hepatocellular carcinoma (HCC) remains challenging in clinical practice. Although sorafenib, an antiangiogenic targeted compound, has demonstrated survival benefits as a first-line therapy, the response rate and time to progression are not optimal. Metronomic chemotherapy has demonstrated antiangiogenic effects, and its reduced potential for toxicity renders it more tolerable to most advanced HCC patients. Clinical trials and retrospective studies have examined the use of metronomic chemotherapy, either alone or in combination with other antiangiogenic therapies, for treating advanced HCC. These studies have confirmed the feasibility and safety of metronomic therapy in patients with advanced HCC. Although objective responses were achieved using metronomic chemotherapy alone, it is difficult to discern the actual clinical benefits because of the small sample sizes of these studies. Nevertheless, metronomic chemotherapy can serve as a treatment option for advanced HCC patients who have progressed on or are intolerable to the standard therapy, sorafenib. In single-arm phase II clinical trials, combining metronomic chemotherapy with antiangiogenic targeted therapy has demonstrated improved efficacy for treating advanced HCC without increasing toxicities. Further research is warranted to confirm the benefits of combining metronomic chemotherapy with antiangiogenic targeted therapy for treating advanced HCC.

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Authors and Affiliations

  1. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan

    Yu-Yun Shao, Ann-Lii Cheng & Chih-Hung Hsu

  2. Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan

    Yu-Yun Shao & Chih-Hung Hsu

  3. Department of Internal Medicine, Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan

    Ann-Lii Cheng

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  1. Division of Pharmacology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

    Guido Bocci

  2. Department of Biological Sciences, University of Texas at El Paso, El Paso, Texas, USA

    Giulio Francia

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Shao, YY., Cheng, AL., Hsu, CH. (2014). Clinical Activity of Metronomic Chemotherapy in Liver Cancers. In: Bocci, G., Francia, G. (eds) Metronomic Chemotherapy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43604-2_13

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