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Metronomic chemotherapy (mCHT) refers to the minimum biologically effective dose of a chemotherapy agent given as a continuous dosing regimen, with no prolonged drug-free breaks, that leads to antitumor activity. Aim of the present study is to describe the use of mCHT in a retrospective cohort of metastatic breast cancer (MBC) patients in order to collect data regarding the different types and regimens of drugs employed, their efficacy and safety. Between January 2011 and December 2016, data of 584 metastatic breast cancer patients treated with mCHT were collected. The use of VRL-based regimens increased during the time of observation (2011: 16.8% - 2016: 29.8%), as well as CTX-based ones (2011: 17.1% - 2016: 25.6%), whereas CAPE-based and MTX-based regimens remained stable. In the 1st-line setting, the highest ORR and DCR were observed for VRL-based regimens (single agent: 44% and 88%; combination: 36.7% and 82.4%, respectively). Assuming VRL-single agent as the referee treatment (median PFS: 7.2 months, 95% CI: 5.3-10.3), the longest median PFS were observed in VRL-combination regimens (9.5, 95%CI 88.8-11.3, HR = 0.72) and in CAPE-single agent (10.7, 95%CI 8.3-15.8, HR = 0.70). The VICTOR-6 study provides new data coming from the real-life setting, by adding new information regarding the use of mCHT as an option of treatment for MBC patients., (Copyright © 2019. Published by Elsevier Ltd.)

Background: The aim of the study was to evaluate the safety and efficacy of the raltitrexed/5-fluorouracil/levofolinic acid combination regimen as first-line chemotherapy for elderly patients with advanced/metastatic colorectal cancer., Patients and Methods: Previously untreated patients with metastatic colorectal cancer received raltitrexed 2 mg/m(2) i.v. plus levofolinic acid and 5-fluorouracil according to the De Gramont' schedule given every 2 weeks as first-line chemotherapy. Patients were re-evaluated after six cycles and chemotherapy was continued up to tolerance or disease progression., Results: Seventy patients aged >/=65 years were accrued from 11 centers between September 2001 and July 2002. According to the intention-to-treat analysis, the overall response rate was 35% (95% CI 29.5% to 40.5%) including one complete response (1%) and 24 partial responses (34%). Twenty patients (31%) showed a stabilization of disease for a tumor growth control rate of 64% (95% CI 57% to 71%). The median overall survival was 12.5 months and the median time to disease progression was 6.5 months. No toxic deaths or allergic reaction were recorded. Grade 4 toxicities were non-existent. The main hematological toxicity was grade 3 neutropenia, which occurred in 9% of patients, and grade 3 anemia in only one case, while no case of graded 3 thrombocytopenia was observed. Grade 3 non-hematological toxicities were asthenia (11%), transient increase of transaminases (10%) and diarrhea (4%)., Conclusions: The results of this study suggest that the raltitrexed/5-fluorouracil/levolofinic acid combination is an effective and well tolerated regimen for the treatment of elderly patients with advanced colorectal cancer. Its ease of administration and patient's tolerance warrant further investigation over 5-fluorouracil/folinic acid regimens.

Purpose: Gemcitabine (GEM) and vinorelbine (VNR) are both active against advanced breast cancer (ABC), being able to induce a median ORR of 25% and 40%, respectively. Because of their different mechanism of action and good tolerability, the combination of GEM and VNR has been tested in ABC., Patients and Methods: Twenty-nine ABC patients pretreated with anthracycline-taxane were treated with GEM 1000 mg/m2 on day 1, 8, 15, and VNR 25 mg/m2 on day 1 and 8 every twenty-eight days. Analysis of toxicity pattern, response rate, TTP and OS were carried out., Results: Twenty-nine patients were enrolled into the trial. The ORR was 48% (95% CI: 29-67): a CR was observed in three patients (10%; 95% CI: 2-27), while eleven patients (38%; 95 CI: 21-58) achieved PR, eight (28%) had a SD, and seven (24%) progressed. Toxicity was mainly hematological and included: grade 3 leukopenia in 48% of cases without episodes of neutropenic fever, grade 3-4 thrombocytopenia in 10%, and grade 2 anemia in 7%. Non-hematological toxicities were mild and rather infrequent., Conclusions: The GEM-VNR combination seems to be active in pretreated ABC with an acceptable toxicity pattern, and may well reppresent an interesting therapeutic choice after anthracycline/taxane regimens.