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Metronomic Chemotherapy: A Game-Changer for Cancer Treatment

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Metronomic Chemotherapy: A Game-Changer for Cancer Treatment

Chemotherapy drugs have traditionally been administered through intravenous “cycles” in hospitals, often with high doses that patients find difficult to tolerate. However, a new study published in the scientific journal Jama Oncology suggests that taking chemotherapy drugs in pill form at home and at lower doses, even every day, could be a more effective and tolerable approach.

The study, known as METEORA-II, focused on women with metastatic breast cancer of the “luminal” type, which represents 70% of all breast tumors and has a positive hormone receptor. It recruited 140 patients from 15 Italian oncology centers who had already undergone a cycle of chemotherapy or two cycles of hormone therapy. The patients were divided into two groups: one followed a metronomic scheme, taking a combination of vinorelbine, cyclophosphamide, and capecitabine, while the other group received traditional intravenous chemotherapy with paclitaxel in the hospital.

The results showed that the patients in the metronomic group had superior efficacy and experienced fewer side effects compared to those receiving traditional chemotherapy. The metronomic therapy slowed down the progression of the disease by approximately 4 months and reduced the risk of therapy interruption due to side effects. At 12 months, 34.3% of patients in the metronomic group continued to benefit from treatment, compared to 8.6% in the other group. Furthermore, progression-free survival was significantly longer in the metronomic group (11.1 months) compared to the traditional chemotherapy group (6.9 months).

In addition to its efficacy, metronomic therapy offers significant advantages for the quality of life of patients. It eliminates the need for monthly hospital visits for high-dose drug infusions, which can lead to significant adverse effects, including hair loss. Although there are still toxicities with metronomic administration, they can be managed through personalized treatment plans that take into account each patient’s characteristics and response to the drugs. It is therefore recommended that patients receive metronomic therapy in specialized oncology centers that focus on precision medicine.

Metronomic therapy, which takes its name from the metronome that “marks the rhythm” in music, involves administering drugs at different times to achieve prolonged benefits with less toxicity. The strategy is gaining ground both in Italy and abroad and is already being used in numerous centers across the country. The Ieo Institute has been studying metronomic therapy for the past 25 years, based on preclinical evidence highlighting the importance of timings and methods of administration in chemotherapy treatments. The preliminary results of the METEORA-II trial were presented at the European Society of Medical Oncology congress in September 2022, and its publication now confirms the value of metronomic administration in comparison to traditional administration.

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Metronomic therapy shows promise in not only advanced-stage breast cancer but also in some forms of metastatic lung and gastrointestinal tract cancer, lymphomas, and certain pediatric tumors. With its potential to improve efficacy, reduce side effects, and enhance patients’ quality of life, this innovative approach to chemotherapy is likely to revolutionize cancer treatment in the future.

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