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Pilot phase II study of metronomic chemotherapy in combination with bevacizumab in patients with advanced non-squamous non-small cell lung cancer
Benjamin S. Jones, Mary S. Jerome, Deborah Miley et al.
Commentary by Stefan Zimmermann
Since the term was coined in 2000 by Browder et al and Klement et al, metronomic chemotherapy has been extensively studied as an antiangiogenic cancer therapy, relying on lower doses and more frequent administration of chemotherapeutics, often in combination with “pure” antiangiogenics such as bevacizumab, with the power to reduce the toxic effects and prevent rapid vascular regrowth that can lead to tumour growth during therapy breaks in conventional schedules. Nevertheless, the optimal role for this modality in the treatment sequence, and its efficacy compared with standard of care chemotherapy, in advanced NSCLC is unknown. The present study demonstrates a longer time to progression and overall survival compared with historical controls, and provides a first hint that first-line metronomic chemotherapy might be of interest, and definitely warrants further exploration, particularly in times when first-line therapy paradigms are changing so rapidly.