Book contents
- Frontmatter
- Contents
- Contributors
- Overview: Biology Is the Foundation of Therapy
- PART I BASIC RESEARCH
- PART II CLINICAL RESEARCH
- 23 Introduction to Clinical Research
- 24 Sarcoma
- 25 Neuroblastoma
- 26 Retinoblastoma
- 27 Primary Brain Tumors and Cerebral Metastases
- 28 Head and Neck Cancer Metastasis
- 29 Cutaneous Melanoma: Therapeutic Approaches for Metastatic Disease
- 30 Gastric Cancer Metastasis
- 31 Metastatic Pancreatic Cancer
- 32 Metastasis of Primary Liver Cancer
- 33 Advances in Management of Metastatic Colorectal Cancer
- 34 Lung Cancer Metastasis
- 35 Metastatic Thyroid Cancer: Evaluation and Treatment
- 36 Metastatic Renal Cell Carcinoma
- 37 Bladder Cancer
- 38 Bone Complications of Myeloma and Lymphoma
- 39 Breast Metastasis
- 40 Gynecologic Malignancies
- 41 Prostate Cancer Metastasis: Thoughts on Biology and Therapeutics
- 42 The Biology and Treatment of Metastatic Testicular Cancer
- 43 Applications of Proteomics to Metastasis Diagnosis and Individualized Therapy
- 44 Critical Issues of Research on Circulating and Disseminated Tumor Cells in Cancer Patients
- 45 Lymphatic Mapping and Sentinel Lymph Node Biopsy
- 46 Molecular Imaging and Metastasis
- 47 Preserving Bone Health in Malignancy and Complications of Bone Metastases
- 48 Role of Platelets and Thrombin in Metastasis
- THERAPIES
- 49 Cancer Nanotechnology Offers Great Promise for Cancer Research and Therapy
- 50 Metronomic Chemotherapy for Treatment of Metastatic Disease: From Preclinical Research to Clinical Trials
- 51 Immunotherapy
- 52 Discovery and Development of Drugs Targeting Tumor Invasion and Metastasis
- 53 The Role of Radiotherapy in the Treatment of Metastatic Disease
- 54 Prospects for Clinical Trials of Metastasis Inhibitors
- Index
- References
50 - Metronomic Chemotherapy for Treatment of Metastatic Disease: From Preclinical Research to Clinical Trials
from THERAPIES
Published online by Cambridge University Press: 05 June 2012
- Frontmatter
- Contents
- Contributors
- Overview: Biology Is the Foundation of Therapy
- PART I BASIC RESEARCH
- PART II CLINICAL RESEARCH
- 23 Introduction to Clinical Research
- 24 Sarcoma
- 25 Neuroblastoma
- 26 Retinoblastoma
- 27 Primary Brain Tumors and Cerebral Metastases
- 28 Head and Neck Cancer Metastasis
- 29 Cutaneous Melanoma: Therapeutic Approaches for Metastatic Disease
- 30 Gastric Cancer Metastasis
- 31 Metastatic Pancreatic Cancer
- 32 Metastasis of Primary Liver Cancer
- 33 Advances in Management of Metastatic Colorectal Cancer
- 34 Lung Cancer Metastasis
- 35 Metastatic Thyroid Cancer: Evaluation and Treatment
- 36 Metastatic Renal Cell Carcinoma
- 37 Bladder Cancer
- 38 Bone Complications of Myeloma and Lymphoma
- 39 Breast Metastasis
- 40 Gynecologic Malignancies
- 41 Prostate Cancer Metastasis: Thoughts on Biology and Therapeutics
- 42 The Biology and Treatment of Metastatic Testicular Cancer
- 43 Applications of Proteomics to Metastasis Diagnosis and Individualized Therapy
- 44 Critical Issues of Research on Circulating and Disseminated Tumor Cells in Cancer Patients
- 45 Lymphatic Mapping and Sentinel Lymph Node Biopsy
- 46 Molecular Imaging and Metastasis
- 47 Preserving Bone Health in Malignancy and Complications of Bone Metastases
- 48 Role of Platelets and Thrombin in Metastasis
- THERAPIES
- 49 Cancer Nanotechnology Offers Great Promise for Cancer Research and Therapy
- 50 Metronomic Chemotherapy for Treatment of Metastatic Disease: From Preclinical Research to Clinical Trials
- 51 Immunotherapy
- 52 Discovery and Development of Drugs Targeting Tumor Invasion and Metastasis
- 53 The Role of Radiotherapy in the Treatment of Metastatic Disease
- 54 Prospects for Clinical Trials of Metastasis Inhibitors
- Index
- References
Summary
Metastasis is the culmination of tumor progression and remains both the primary cause of mortality for cancer patients, as well as the most challenging aspect of cancer therapy. The main systemic treatment of metastatic disease – chemotherapy – was designed with the aim of killing as many tumor cells as possible by using cytotoxic agents at the maximum tolerated dose (MTD) [1, 2]. However, such regimens are associated with a number of inherent limitations. For instance, the administration of high dosages of chemotherapeutic agents results in toxicity, which is sometimes serious in nature (e.g., myelosuppression and damage to intestinal mucosa). As such, this requires the incorporation of prolonged breaks (often, three weeks) between treatments to allow recovery of depleted cells (e.g., neutrophils from bone marrow progenitors) [3]. Unfortunately, these breaks also allow for tumor regrowth to occur such that any regressions achieved by MTD therapy are usually only transitory [2]. In addition, due to the inherent ability of tumor cells to acquire resistance to cytotoxic agents, most MTD therapies eventually fail, resulting in resumption of disease progression. Overall, most MTD therapies have proven generally ineffective or of modest (mostly palliative) benefit in the treatment of advanced metastatic disease [3].
Clearly, a rethinking of approaches to treat metastatic disease is in order. This involves, at least in part, a reexamination of the dosing schedule regimens of chemotherapeutic agents that are best suited to treat this most intractable aspect of the pathology of cancer.
- Type
- Chapter
- Information
- Cancer MetastasisBiologic Basis and Therapeutics, pp. 573 - 586Publisher: Cambridge University PressPrint publication year: 2011
References
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