The Biomodulatory Capacities of Low-Dose Metronomic Chemotherapy: Complex Modulation of the Tumor Microenvironment

摘要: The cyclic administration of conventional (i.e., maximum ­tolerated dose [MTD]) chemotherapy targets primarily the tumor cell population. In contrast, chemotherapeutics used at lower doses but on a more frequent basis, and without treatment-free breaks, preferentially affect vasculature. This so-called low-dose metronomic (LDM) form can be considered as complementary and/or alternative antiangiogenic therapy to use targeted agents such antibodies or small molecule drugs that interfere with vascular endothelial growth factor (VEGF) pathways. However, it becomes increasingly clear LDM affects also aspects microenvironment other than angiogenesis immune responses. Herein, we summarize complex effects microenvironment, special emphasis angiogenesis. We compare versus MTD chemotherapy. Finally, outline how pharmacogenetic characteristics host may exploited in future predict response therapy.