Study of metronomic chemotherapy in cancer patients at a tertiary care center in South India

Background and Objectives: Metronomic chemotherapy is a treatment regimen which involves the administration of low-dose chemotherapy frequently with shorter drug-free intervals. In India, a majority of the patients diagnosed with cancer present to the health-care providers at an advanced stage. Moreover, they are often from the lower socioeconomic strata with limited access to health care. Metronomic chemotherapy is a convenient, minimally toxic, and economically viable treatment option whose potential should be explored. Materials and Methods: We retrospectively reviewed the data of 100 patients diagnosed with cancer who received metronomic chemotherapy in a tertiary cancer care center. The records of all the patients who visited the cancer care center between September 2015 and February 2017 were reviewed. Data on age, sex, address, diagnosis with staging, sequence of prior treatment received, and duration of metronomic chemotherapy, reasons for discontinuing metronomic chemotherapy, response, toxicity profile, and outcome were collected and analyzed. The statistical analysis was performed using SPSS statistics software, version 23.0. The survival analysis was done using the Kaplan–Meier survival analysis. Results: The mean age of patients was 53.75 years (32–92 years). About 60% were in Stage 4. With therapy, 79% improved, 16% deteriorated, and 5% were stable in their symptom profile. The mean disease progression-free survival was 232 days, while the overall survival was 310 days. Interpretation and Conclusion: Metronomic therapy is a feasible option in the palliative care setting. It does not require stringent monitoring, as it has a well-tolerated side effect profile when compared to conventional chemotherapy. Its utility in patients being treated with curative intent and the criteria for response assessment with low-cost imaging has to be explored.