Digklia Antonia, Voutsadakis Ioannis A
Antonia Digklia, Department of Medical Oncology, University Hospital of Lausanne, 1011 Lausanne, Switzerland.
World J Exp Med. 2014 Nov 20;4(4):58-67. doi: 10.5493/wjem.v4.i4.58.
Chemotherapy given in a metronomic manner can be administered with less adverse effects which are common with conventional schedules such as myelotoxicity and gastrointestinal toxicity and thus may be appropriate for older patients and patients with decreased performance status. Efficacy has been observed in several settings. An opportunity to improve the efficacy of metronomic schedules without significantly increasing toxicity presents with the addition of anti-angiogenic targeted treatments. These combinations rational stems from the understanding of the importance of angiogenesis in the mechanism of action of metronomic chemotherapy which may be augmented by specific targeting of the vascular endothelial growth factor (VEGF) pathway by antibodies or small tyrosine kinase inhibitors. Combinations of metronomic chemotherapy schedules with VEGF pathway targeting drugs will be discussed in this paper.
采用节拍式给药的化疗所产生的不良反应较少，而这些不良反应在传统化疗方案中很常见，如骨髓毒性和胃肠道毒性，因此可能适用于老年患者和身体状况较差的患者。在多种情况下都观察到了疗效。通过添加抗血管生成靶向治疗，有机会在不显著增加毒性的情况下提高节拍式化疗方案的疗效。这些联合用药的合理性源于对血管生成在节拍式化疗作用机制中的重要性的认识，通过抗体或小酪氨酸激酶抑制剂对血管内皮生长因子（VEGF）途径进行特异性靶向可能会增强这种作用。本文将讨论节拍式化疗方案与VEGF途径靶向药物的联合应用。
