Metronomic chemotherapy and immunotherapy in cancer treatment
Journal
Cancer Letters
Journal Volume
400
Pages
282-292
Date Issued
2017
Author(s)
Abstract
Systemic chemotherapy given at maximum tolerated doses (MTD) has been the mainstay of cancer treatment for more than half a century. In some chemosensitive diseases such as hematologic malignancies and solid tumors, MTD has led to complete remission and even cure. The combination of maintenance therapy and standard MTD also can generate good disease control; however, resistance to chemotherapy and disease metastasis still remain major obstacles to successful cancer treatment in the majority of advanced tumors. Metronomic chemotherapy, defined as frequent administration of chemotherapeutic agents at a non-toxic dose without extended rest periods, was originally designed to overcome drug resistance by shifting the therapeutic target from tumor cells to tumor endothelial cells. Metronomic chemotherapy also exerts anti-tumor effects on the immune system (immunomodulation) and tumor cells. The goal of immunotherapy is to enhance host anti-tumor immunities. Adding immunomodulators such as metronomic chemotherapy to immunotherapy can improve the clinical outcomes in a synergistic manner. Here, we review the anti-tumor mechanisms of metronomic chemotherapy and the preliminary research addressing the combination of immunotherapy and metronomic chemotherapy for cancer treatment in animal models and in clinical setting. ? 2017 Elsevier B.V.
SDGs
Other Subjects
alpha interferon; bevacizumab; capecitabine; celecoxib; cyclophosphamide; dacarbazine; daunorubicin; dendritic cell vaccine; DNA vaccine; doxorubicin; etoricoxib; fluorouracil; gemcitabine; interleukin 12; interleukin 2; methotrexate; oncolytic adenovirus; paclitaxel; pioglitazone; racotumomab; temozolomide; vinblastine; vincristine; angiogenesis inhibitor; antineoplastic agent; immunologic factor; antiangiogenic activity; cancer chemotherapy; cancer gene therapy; cancer immunotherapy; cancer resistance; cancer stem cell; glioma; human; immunomodulation; immunosurveillance; kidney metastasis; liver cell carcinoma; low drug dose; maximum tolerated dose; melanoma; metastatic breast cancer; metastatic melanoma; metronomic drug administration; multiple cycle treatment; myeloid-derived suppressor cell; nonhuman; ovary cancer; overall survival; pancreas tumor; priority journal; Short Survey; solid malignant neoplasm; tumor associated leukocyte; tumor escape; tumor microenvironment; tumor regression; adverse effects; animal; dose response; drug effects; immunology; immunotherapy; metronomic drug administration; Neoplasms; neovascularization (pathology); pathology; procedures; treatment outcome; vascularization; Administration, Metronomic; Angiogenesis Inhibitors; Animals; Antineoplastic Agents; Dose-Response Relationship, Drug; Humans; Immunologic Factors; Immunotherapy; Neoplasms; Neovascularization, Pathologic; Treatment Outcome; Tumor Escape
Publisher
Elsevier Ireland Ltd
Type
review