Effects of low-dose chemotherapy on colorectal cancer survival

1. Metronomic Capecitabine as Maintenance Treatment after First-Line Induction with XELOX for Metastatic Colorectal Cancer Patients

  • Source: Medicine (Baltimore), 2020
  • Summary: Metronomic capecitabine maintenance therapy significantly improved progression-free survival (PFS) compared to observation alone in metastatic colorectal cancer (mCRC) patients, though overall survival (OS) was not significantly different. This indicates a potential benefit of metronomic chemotherapy for disease control​​.

2. MOMENTUM: A Phase I Trial Investigating Two Schedules of Capecitabine with Aflibercept in Patients with Gastrointestinal and Breast Cancer

  • Source: Clinical Colorectal Cancer, 2020
  • Summary: This study showed that metronomic capecitabine with aflibercept was feasible and had a manageable safety profile with some anti-tumor activity in chemorefractory gastrointestinal and breast cancer patients​​.

3. Metronomic Capecitabine with Cyclophosphamide Regimen in Unresectable or Relapsed Pseudomyxoma Peritonei

  • Source: Clinical Colorectal Cancer, 2019
  • Summary: The combination of metronomic capecitabine and cyclophosphamide demonstrated a disease control rate (DCR) of 87% and a manageable safety profile, indicating potential survival benefits for patients with pseudomyxoma peritonei​​.

4. Phase II Randomized Study of Maintenance Treatment with Bevacizumab or Bevacizumab Plus Metronomic Chemotherapy after First-Line Induction with FOLFOXIRI Plus Bevacizumab for Metastatic Colorectal Cancer Patients: The MOMA Trial

  • Source: European Journal of Cancer, 2019
  • Summary: This study found that adding metronomic chemotherapy to bevacizumab maintenance therapy did not significantly improve PFS compared to bevacizumab alone. However, the treatment was well tolerated​​.

5. Effect of Modified Vaccinia Ankara-5T4 and Low-Dose Cyclophosphamide on Antitumor Immunity in Metastatic Colorectal Cancer: A Randomized Clinical Trial

  • Source: JAMA Oncology, 2017
  • Summary: Combining low-dose cyclophosphamide with an MVA-5T4 vaccine significantly improved PFS and OS in metastatic colorectal cancer patients, highlighting the potential for enhanced antitumor immunity and survival benefits​​.

6. Continuous, Low-Dose Capecitabine for Patients with Recurrent Colorectal Cancer

  • Source: Medical Oncology, 2015
  • Summary: Low-dose metronomic capecitabine was moderately active and well-tolerated in pretreated or frail patients with recurrent colorectal cancer, showing potential benefits for disease control and survival​​.

7. A Phase 1 Trial of Imatinib, Bevacizumab, and Metronomic Cyclophosphamide in Advanced Colorectal Cancer

  • Source: British Journal of Cancer, 2013
  • Summary: The combination of imatinib, bevacizumab, and metronomic cyclophosphamide was safe and tolerable, with a subset of patients experiencing prolonged stable disease, suggesting potential benefits for survival​​.

8. A Randomized Study of KRAS-Guided Maintenance Therapy with Bevacizumab, Erlotinib, or Metronomic Capecitabine after First-Line Induction Treatment of Metastatic Colorectal Cancer: The Nordic ACT2 Trial

  • Source: Annals of Oncology, 2016
  • Summary: The trial indicated that low-dose capecitabine as maintenance therapy did not significantly improve PFS or OS compared to other maintenance strategies but showed enough potential to warrant further investigation​​.

9. Dosage Escalation Study of S-1 and Irinotecan in Metronomic Chemotherapy Against Advanced Colorectal Cancer

  • Source: Kurume Medical Journal, 2009
  • Summary: This phase I study established the recommended dose for a metronomic chemotherapy regimen with S-1 and irinotecan, demonstrating acceptable safety and promising efficacy for further clinical trials​​.

Overall, these studies suggest that low-dose or metronomic chemotherapy can positively impact disease control and progression-free survival in various cancers, particularly colorectal cancer. While overall survival improvements are not always statistically significant, the approach is generally well-tolerated and offers promising benefits for disease management and progression-free survival.

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