Recent clinical evidence on metronomic dosing in controlled clinical trials : a systematic literature review
Year of publication
2020
Authors
Wichmann, Viktor; Eigeliene, Natalja; Saarenheimo, Jatta; Jekunen, Antti
Abstract
Introduction: Metronomic dosing is used to give continuous chemotherapy at low doses. The low doses have minimal side effects and may enable cancer treatment to be remodeled toward the management of chronic disease. Methods: We searched PubMed database to obtain relevant clinical trials studying metronomic chemotherapy (MCT). Our main focus was to find controlled phase II and phase III trials. Results: This systematic review summarizes the results of 91 clinical reports focusing on randomized phase II and phase III clinical studies between 2012 and 2018. During that time, nine randomized phase II and 10 randomized phase III studies were published. In the majority of the studies, MCT was well tolerated, and major side effects were rarely seen. Altogether, 4 phase III studies and 4 randomized phase II studies presented positive results and some clinical benefit. Discussion: Most of the studies did not show significantly improved overall survival or progression-free survival. Typically, the metronomic dosing was explored in a maintenance setup and was added to other agents given within normal high doses, whereas no trial was performed challenging metronomic dosing and best supportive care in later treatment lines. Therefore, there is no definite evidence on the efficacy of single metronomic dosing and firm evidence of metronomic dosing is still missing. There is a need for further confirmation of the usefulness of this approach in clinical practice.
Show moreOrganizations and authors
University of Turku
Jekunen Antti
Turku University Hospital Catchment Area
Jekunen Antti
Saarenheimo Jatta
Eigeliene Natalija
Wichmann Viktor
Publication type
Publication format
Article
Parent publication type
Journal
Article type
Review article
Audience
ScientificPeer-reviewed
Peer-ReviewedMINEDU's publication type classification code
A2 Review article, Literature review, Systematic reviewPublication channel information
Journal
Publisher
Volume
59
Issue
7
Pages
775-785
ISSN
Publication forum
Publication forum level
1
Open access
Open access in the publisher’s service
No
Self-archived
No
Other information
Fields of science
Cancers; Pharmacy
Keywords
[object Object],[object Object],[object Object],[object Object]
Publication country
United Kingdom
Internationality of the publisher
International
Language
English
International co-publication
No
Co-publication with a company
No
DOI
10.1080/0284186X.2020.1744719
The publication is included in the Ministry of Education and Culture’s Publication data collection
Yes