Metronomic Chemotherapy in Triple-Negative Metastatic Breast Cancer: The Future Is Now?

Table 1

Summary of data in the (neo)adjuvant setting.

Author (year)	Setting/type of trial	Drug(s)	Number of patients	Results
Pruneri et al. [6]	Adj/Phase III	CTX 50 mg/day orally continuously for 1 year and MTX 2.5 mg/twice a day orally, days 1 and 2 of every week for 1 year; versus; no maintenance chemotherapy	647	BCFI risk reduction: 13%; DFS risk reduction: 11%; DFRI risk reduction: 16%; OS risk reduction: 17%; (for every 10% increase of TILs)
Nasr et al. [7]	Adj/Phase II	Group 1	158 (whole population); 78	mDFS; 28 versus 24 months; mOS; 37 versus 29; Distant mets recurrence rate 26% versus 37%
		FEC-100 × 3 cycles
		Docetaxel 80 mg/m^2 + Carboplatin AUC 5; Followed by
		CTX 50 mg/day + MTX 2,5 mg bid, days 1 and 2 every week
Masuda et al. [8]	(Neo)adj/Phase II	mPTX 80 mg/m^2 days 1, 8, and 15		pCR 47.5%; cORR 90%
		CTX 50 mg/day
		CAPE 1200 mg/m^2, daily	40
		Followed by
		FEC100
Shawky and Galal [9]	Adj/Phase II	mCAPE 650 mg/m^2, twice every day, after standard adjuvant chemotherapy for 1 year	19	2 ys-DFS rate 88.8%; 3 ys-DFS rate 82.05%
Alagizy et al. [10]	Adj/Phase II	CAPE 500 mg twice daily continuously for 6 months after finishing six cycles of adjuvant FEC100	41	Mean DFS 42.4 months

EPI = epirubicin; CDDP = cisplatin; 5FU = 5-fluorouracil; PTX = paclitaxel; CTX = Cyclophosphamide; CAPE = capecitabine; mCAPE = metronomic capecitabine; FEC100 = 5FU + EPI 100 mg/m² + CTX; MTX = methotrexate; cCR = clinical complete response; cPR = clinical partial response; pCR = pathologic complete response; DFS = disease free survival; BCFI = breast cancer free interval; DFRI = distant recurrence free interval; OS = overall survival.