Anyone had metronomic therapy?

Hi Leah. I do remember having a discussion with my onc about it. From my understanding it was "maintenance" therapy if and when tumor burden was deemed manageable after traditional max dose/cycle therapy. Good luck to you.

Hi Leah, Sorry I don't stop by as often anymore or I would have responded sooner. Metronomic therapy refers pretty much to any chemo schedule (including single and combo chemo's) that is delivered frequently as possible (daily or weekly) with dose reductions until they are very tolerable symptom wise. And its a very hot research topic right now. Fueled in part by the excellent results of Xeloda (capecitabine) and the problems with Avastin (bevacizumab) Oncologists are exploring the use of a whole bunch of older drugs (and drug combos) that are delivered in smarter way. What is fascinating everybody is the understanding that the same chemo drugs administered in these low frequent drug schedules work differently than they do in high test/dose chemo regimes.

So included here would be a number of regimes that ladies on this board are having good success with - Capecitabine daily of course, navelbine or gemzar (gemcitabine) weekly, Adriamycin (weekly with heart protection), and cm or cmf regimes noted above). There are more showing up as other older drugs are being thrown into the mix. Because the drugs work differently when administered this way they are being tried out with unusual drugs that boost the impact theoretically including being paired with hormonal drugs, NSAID's esp COX2 inhibitors, steriods and even thalidimide.

Some of the understanding of the differences include - metronomic chemo's have a strong anti-angiogenic effects not seen with high dose chemos (understood to work in very particular ways within the cell life cycle). Metronomic approaches also seem to be strong immune system simulators. Also they have different ways of failing - the cancer itself is believed to not become resistant to the drug but rather its an epidural cell resistance - leading to good questions and more research to determine if these drugs can be returned to after sufficient rest periods. So they work the body to do extra things that resist cancer rather than just directly killing cancer cells.

Anyway to understand your combo better - google metronomic and then the particular drugs involved. Research is going on with a wide array of cancers and there will be lots more we'll be hearing about I'm sure.

My personal experience is that these are the best of the quality of life chemo's and they can have fair longevity if one responds. They are go to's for the elderly, for those needing breaks from tougher chemo's and for those who are known chemo responders, for those caught without funds/insurance - they can handle serious disease but less likely than powerhouses chemo's to result in CR although as Xeloda users know its not unheard of. The more chemo's one does of course the less dramatic the result is likely to be. Most chemo drugs perform great first and second line. This a long haul approach. Its also a way cheaper approach so countries with public funded health care will see a stronger uptake I'm sure. But the data is backing it's effectiveness, and lots of work being done, so its a very interesting option.

Thats my understanding - hope it helps

Sophie

This is an older thread, but I just started metronomic low-dose oral cyclophosphamide and methotrexate. Literally, I took my first pill just now. Anyone else on this? I'm interested in what people experience for side effects...