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Metronomic Chemotherapy in Non-Small-Cell Lung Cancer

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Metronomic Chemotherapy

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Abstract

Metronomic chemotherapy is an alternative approach for the administration of systemic chemotherapy that consists of the administration of low doses of a cytotoxic regimen without any interruptions. Endothelial cells of the tumor blood vessels are rapidly proliferating cells that could be affected with the metronomic use of chemotherapy. Indeed, it is strongly believed that this strategy inhibits vascular angiogenesis and subsequently tumor growth mainly through modulating the cancer microenvironment with favorable toxicity profile. In addition, immune suppression is a reality among the vast majority of cancer patients. T regulatory cells (Tregs) are the main representative of suppressive cells, and their increased expression in cancer has been associated with worse prognosis and tumor progression. Low doses of chemotherapeutic agents have been proven capable to restore the normal immune system function through the elimination of immune suppressive cells. Numerous studies have investigated the efficacy of metronomic strategy in NSCLC patients with very promising results. Several chemotherapeutic agents, such as vinorelbine, gemcitabine, cyclophosphamide, and docetaxel, have been tested as monotherapy or in combination with other drugs. Whether other mechanisms, such as tumor dormancy, are also involved in the effectiveness of metronomic administration of chemotherapy or if it is superior to conventional chemotherapy remains questionable, and further investigation is required.

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Authors and Affiliations

  1. Department of Medical Oncology, University General Hospital of Heraklion, 1352, Heraklion, Crete, 711 10, Greece

    Athanasios Kotsakis & Vassilis Georgoulias MD, PhD

  2. 251 General Hospital of Air Force, 227-231 Mesogion Ave., 155 61, Cholargos, Athens, Greece

    Nikolaos Kentepozidis

Authors
  1. Athanasios Kotsakis
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  2. Nikolaos Kentepozidis
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  3. Vassilis Georgoulias MD, PhD
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Correspondence to Vassilis Georgoulias MD, PhD .

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Editors and Affiliations

  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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Kotsakis, A., Kentepozidis, N., Georgoulias, V. (2014). Metronomic Chemotherapy in Non-Small-Cell Lung Cancer. In: Bocci, G., Francia, G. (eds) Metronomic Chemotherapy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43604-2_15

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