The most extensive published clinical experience with metronomic chemotherapy regimens has been provided by oncologists in Milan, who have documented the long-term responses of patients with metastatic breast cancer to a metronomic regimen involving daily cyclophosphamide (50mg) and two weekly doses of methotrexate (5mg per dose) (10,11). From the patients using this regimen, 32% achieved either a complete or partial remission, or a stabilization of disease lasting at least 24 weeks. In about 16% of patients, no tumor progression was noted for over a year. Even in the patients in whom progression did occur, it seems likely that the therapy was often slowing the spread of the disease. The especially good news, since metronomic chemotherapy is intended for long-term use, is that this regimen was essentially free of annoying side effects. Only a mild suppression of white cell count was observed in a small minority of the treated patients.
Since metronomic therapy is directed against endothelial cells, not cancer cells, a metronomic regimen that works well with one type of cancer should work well with all types of cancer dependent on angiogenesis for growth. At Oasis of Hope, we use a metronomic regimen like that tested by the Milanese doctors. It is based on cyclophosphamide, also known by its trade name “Genoxal”. We also include methotrexate for selected patients.
The Oasis of Hope CMIT at-home protocols include additional agents intended to slow the process of angiogenesis. These include salsalate, silymarin, fish oil, the glycine in GPG, and the green tea polyphenols in Synerpax. Thus, we are attacking angiogenesis from as many angles as we feasibly can.