Low Dose/Metronomic Chemotherapy

This treatment concept has been referred to by many names including low dose chemotherapy and low dose continuous chemotherapy. However, the most popular title is likely “metronomic chemotherapy.” Just as a metronome, used to keep proper time in music, is unvaryingly regular in its rhythm, so too is a metronomic chemotherapy schedule. This nickname has been applied to chemotherapy regimens with low doses scheduled at regular intervals. This way, patients receive equal or greater amounts of chemotherapy without the harsh side effects of standard high doses and the long recovery period. Unlike in music, where the tempo may be altered in either direction, the goal with metronomic chemotherapy is to maintain the low dosing frequency at a much higher rate than exists in conventional protocols. Lower dose, longer term maintenance chemotherapy protocols have been important components of treatment for certain cancers (such as acute lymphoblastic leukemia) in oncology for decades, but Dr. Chue was one of the first oncologists to use this method regularly for other various types of cancers.

The low dose, metronomic dosing of certain chemotherapy agents, such as paclitaxel, is now an acceptable and standard practice of many oncologists. Still, many oncologists fail to grasp that the generally low cost, high convenience, and acceptable side effect profiles of these protocols make them innovative and attractive for cancer treatment. One reason for the effectiveness of metronomic chemotherapy is because low, continuous doses appear to exhibit antiangiogenic properties which stop the growth of tumors and progression of cancers by limiting the pathologic formation of new blood vessels.

Dr. Chue has always been ahead of the curve when it comes to medicine. Several drug combinations and dosing regimens that he used in the past are now the standard treatment for certain diseases. For example, Dr. Chue has used oxaliplatin and 5-fluorouracil for the treatment of metastatic pancreatic cancer for several years. Now this therapy is the standard treatment for the disease. Dr. Chue always has the latest information about oncology drugs and products and is constantly aware of the most recent advancements. He combines this information with the individual patient’s needs and genetic profile and is able to create a personalized treatment plan.