undefined

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 more

Organizations and authors

University of Jyväskylä

Saarenheimo Jatta Orcid -palvelun logo

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

Scientific

Peer-reviewed

Peer-Reviewed

MINEDU's publication type classification code

A2 Review article, Literature review, Systematic review

Publication channel information

Volume

59

Issue

7

Pages

775-785

​Publication forum

50317

​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