ABSTRACT
One of the most deadly illnesses in recent memory, cancer claims many lives each year. Since a few years ago, a growing number of novel, selective compounds targeted at certain cellular targets have become accessible for cancer therapy, yielding notable advancements. Several cytotoxic medicines have been shown in numerous trials to exhibit antiangiogenic activities when used regularly and at lower dosages than recommended schedules that contain maximally tolerated doses (MTDs). Metronomic chemotherapy, a new approach, focuses on the slowly reproducing cancer endothelial cells as a separate target.
Combining different medications from different classes, each with antiangiogenic, immune-stimulatory, and apoptotic effects, is a common part of the metronomic chemotherapy regimen. This method involves administering low dosages of several antineoplastic medications, including CPA, methotrexate, etoposide, vinblastine, and paclitaxel, repeatedly and often. While sparing non-endothelial cells and leukocytes, these levels have lethal effects on both circulating endothelial cells and circulating endothelial progenitor cells (CEPs). Cyclophosphamide, methotrexate, capecitabine, vinorelbine, and bevacizumab are a few of the drugs that are frequently used.
There are several potential advantages to the synergistic interactions between metronomic chemotherapy and targeted therapy in the treatment of cancer. Contrary to traditional chemotherapy, which can kill both healthy and diseased cells, targeted therapies aim to specifically target cancer cells while protecting healthy cells. New drugs and therapeutic alternatives for metronomic chemotherapy, including drug combinations, immune checkpoint inhibitor combinations, targeted antiangiogenic drugs, and first-line therapy for advanced disease, have been examined in recent studies. These techniques have shown promise in improving outcomes and decreasing toxicity in specific cancer types.
