Nicolas André, Kelvin Tsai, Manon Carré, Eddy Pasquier from the Service d’Hématologie et Oncologie Pédiatrique, Hôpital pour Enfants de La Timone, the Inserm CRO2 UMR_S 911, Aix-Marseille University, the CNRS, INSERM, Aix-Marseille University, Institut Paoli-Calmettes, CCRCM, Marseille, France and the Laboratories for Tumor Aggressiveness and Stemness; National Institute of Cancer Research, National Health Research Institutes; College of Medicine, Taipei Medical University, Taiwan and the Metronomics Global Health Initiative, Marseille, France have just published in Trends In Cancer an opinion piece entitled : Metronomic Chemotherapy: Direct Targeting of Cancer Cells after all?

Metronomic chemotherapy was initially described as an anti-angiogenic therapy more than 15 years ago. Over the last years additional data have highlighted the impact of MC on the microenvironment beyond angiogenesis with most importantly a potential impact on the immune system. Here we review and reappraise the fact that metronomic chemotherapy might be able to directly kill cancer cells. Although long neglected, this question is of critical importance both fundamentally and clinically, especially when considering future associations with immunotherapies.

Key points :

 Initially considered as an antiangiogenic therapy, MC is in fact a multi-targeted antimicroenvironment therapy.

 The fact that MC can directly target cancer cells and cancer stem cells has been neglected.

 MC can impact cancer cell metabolism.

 Several types of cell death, including immunogenic cell death, can be induced by MC.

 MC can impact the ecology of cancer clones without high selective pressure.

You can read the not free full text here.