Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, Seoul, 04763, South Korea.
Department of Molecular and Cellular Biochemistry School of Medicine, Kangwon National University School of Medicine, Chuncheon, Gangwon-do, 24341, South Korea.
Arch Pharm Res. 2019 Jan;42(1):1-13. doi: 10.1007/s12272-018-01102-z. Epub 2019 Jan 2.
Drug resistance and toxic side effects are major therapeutic hurdles affecting cancer patients receiving conventional chemotherapy based on the maximum tolerated dose. Metronomic chemotherapy (MCT), a new therapeutic approach developed to avoid these problems generally, consists of the continuous administration of low-dose cytotoxic agents without extended intervals. This therapy targets the tumor microenvironment, rather than exerting a direct effect on tumor cells. As a result, the MCT regimen functionally impairs tumor endothelial cells and circulating endothelial progenitor cells, leading to tumor dormancy via anti-angiogenesis. Over the past 10 years, several studies have highlighted the impact of MCT on the tumor microenvironment and angiogenesis and demonstrated its potential as a switch from the pro-angiogenic to the anti-angiogenic state. However, the mechanisms of action are still obscure. Here, we systematically review the evidence regarding the anti-angiogenic potential of MCT as a crucial determinant of tumor dormancy and cancer treatment.
耐药性和毒副作用是影响接受最大耐受剂量常规化疗的癌症患者的主要治疗障碍。节拍化疗（MCT）是一种新的治疗方法，旨在避免这些问题，通常包括连续给予低剂量细胞毒性药物而不延长间隔。这种治疗方法针对肿瘤微环境，而不是直接作用于肿瘤细胞。因此，MCT 方案在功能上损害肿瘤内皮细胞和循环内皮祖细胞，通过抗血管生成导致肿瘤休眠。在过去的 10 年中，有几项研究强调了 MCT 对肿瘤微环境和血管生成的影响，并证明了它作为从促血管生成到抗血管生成状态的转变的潜力。然而，其作用机制仍不清楚。在这里，我们系统地回顾了 MCT 作为肿瘤休眠和癌症治疗的关键决定因素的抗血管生成潜力的证据。
