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. 2017 Feb;77(2):142-148.
doi: 10.1055/s-0043-100388.

Metronomic Chemotherapy for Primary Non-Metastatic Breast Cancer - a Systematic Review of the Literature

Malgorzata Banys-Paluchowski  1 , Eugen Ruckhäberle  2 , Florian Schütz  3 , Natalia Krawczyk  2 , Tanja Fehm  2
Affiliations

Metronomic Chemotherapy for Primary Non-Metastatic Breast Cancer - a Systematic Review of the Literature

Malgorzata Banys-Paluchowski et al. Geburtshilfe Frauenheilkd. 2017 Feb.

Abstract
in English, German

Conventional chemotherapy is based on the "maximum tolerated dose" principle and aims at administering high doses of cytotoxic drugs followed by a rest period necessary for the body to recover. In the last decades alternative strategies have been developed to avoid serious side effects of conventional treatment, among them the metronomic chemotherapy. Much like a metronome keeps steady rhythm, metronomic therapy is administered continuously in low doses for a long time. In metastatic breast cancer, metronomic therapy is a valid option in pretreated or vulnerable patients and its use has recently been incorporated into various guidelines. In early breast cancer, the role of metronomic treatment remains to be clarified. A systematic review of PubMed/MEDLINE, ClinicalTrials.gov, the European Clinical Trials Database (EudraCT) and the Cochrane Database was conducted. In the present review, we discuss the current evidence on metronomic chemotherapy in non-metastatic breast cancer.

Die konventionelle Chemotherapie basiert auf das Prinzip der „maximal tolerierbaren Dosis“. Es werden hohe Dosen zytotoxischer Medikamente verabreicht, gefolgt von Ruheperioden, die der Körper zur Erholung benötigt. In den letzten Jahrzehnten wurden auch alternative Strategien entwickelt, um die schwerwiegenden Nebenwirkungen konventioneller Behandlungen zu vermeiden, darunter die metronomische Chemotherapie. Ähnlich dem steten Rhythmus eines Metronoms werden bei der metronomischen Therapie Medikamente kontinuierlich in geringen Dosen und über einen längeren Zeitraum verabreicht. Die metronomische Therapie stellt eine wirksame Behandlungsoption für vorbehandelte oder geschwächte Patientinnen mit metastasierendem Brustkrebs dar, und der Einsatz der metronomischen Therapie wurde vor Kurzem in verschiedene Leitlinien aufgenommen. Die Rolle von metronomischer Therapie bei Brustkrebs im Frühstadium muss noch geklärt werden. Dazu wurde eine systematische Durchsicht von PubMed/MEDLINE, ClinicalTrials.gov, der Datenbank des European-Clinical-Trials-(EudraCT-)Registers und der Cochrane Datenbank durchgeführt. In dieser Übersichtsarbeit wird der aktuelle Forschungsstand zur metronomischen Chemotherapie bei nicht metastasierendem Brustkrebs diskutiert.

Keywords: breast cancer; maintenance therapy; metronomic chemotherapy; survival; systematic review; toxicity.

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Conflict of interest statement

Conflict of Interest None.

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