Low-Dose Metronomic Chemotherapy

ICT delivers Low-Dose Metronomic Chemotherapy to our patients. Low dose metronomic chemotherapy is the prolonged, repetitive, and more frequent use of low doses of chemotherapy drugs to target the endothelium. The endothelium supports the formation of new blood vessels and/or tumor stroma (the abnormal connective tissue which feeds the cancer), rather than targeting the tumor itself. Unlike conventional maximum tolerated dose chemotherapy, this approach does not require the long breaks between treatment cycles to allow the patient to recover. Research suggests that it may be during these long "break" periods in which cancer resistance develops.

The benefits of this approach are decreased toxicity and inhibition of angiogenesis (the development of blood vessels that feed the tumor). During angiogenesis, new endothelial cells are extremely fragile as they branch off from existing blood vessels, multiply, migrate into a tumor, and eventually form into tubular structures to give rise to new vessels. The endothelial cells engaged in angiogenesis are extremely sensitive to killing by these cytotoxic drugs; much more so than most cancer cells. Thus, when low-dose chemotherapy is administered on a regular schedule (hence "metronomic" like the steady beat of a metronome), the continual death of endothelial cells attempting to form new blood vessels can substantially disrupt the angiogenic process.

Additionally, one of the particular merits of this approach centers on cancer drug resistance. Whereas conventional, high-dose chemotherapy accelerates the development of chemotherapy resistant cancer cells, metronomic low dose chemotherapy targets endothelial cells rather than cancer cells. This technique is often associated with less resistance.

Recently, a further benefit of metronomic chemotherapy has been established. It tends to selectively kill a population of immune cells, called "T-reg cells," that function to suppress the activity of immune cells capable of attacking the tumor. T-reg cells often congregate within tumors and secrete hormone-like factors that "turn off" the immune cells, trying to attack the cancer. Thus, metronomic chemotherapy has emerged as a useful adjuvant to the therapeutic strategies intended to boost the tumor-killing capacity of NK and T-cytotoxic cells.

Low dose metronomic chemotherapy may be effective in treating the outer rim of the tumor with less toxicity, but it does not address the interior of the tumor which is anaerobic, hypoxic, and lacks blood supply. By combining this therapy with techniques such as pH Manipulation Therapy, eradication of both the inner and outer sections of the tumor may be possible.