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Immunomodulatory effects of low dose chemotherapy and perspectives of its combination with immunotherapy.

Authors
Type
Published Article
Journal
International Journal of Cancer
1097-0215
Publisher
Wiley Blackwell (John Wiley & Sons)
Publication Date
Volume
132
Issue
11
Pages
2471–2478
Identifiers
DOI: 10.1002/ijc.27801
PMID: 22927096
Source
Medline
License
Unknown

Abstract

Given that cancer is one of the main causes of death worldwide, many efforts have been directed toward discovering new treatments and approaches to cure or control this group of diseases. Chemotherapy is the main treatment for cancer; however, a conventional schedule based on maximum tolerated dose (MTD) shows several side effects and frequently allows the development of drug resistance. On the other side, low dose chemotherapy involves antiangiogenic and immunomodulatory processes that help host to fight against tumor cells, with lower grade of side effects. In this review, we present evidence that metronomic chemotherapy, based on the frequent administration of low or intermediate doses of chemotherapeutics, can be better than or as efficient as MTD. Finally, we present some data indicating that noncytotoxic concentrations of antineoplastic agents are able to both up-regulate the immune system and increase the susceptibility of tumor cells to cytotoxic T lymphocytes. Taken together, data from the literature provides us with sufficient evidence that low concentrations of selected chemotherapeutic agents, rather than conventional high doses, should be evaluated in combination with immunotherapy.

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