Metronomic Chemotherapy in Patients with Advanced Non—Small-Cell Lung Cancer Associated with Long-Term Survival

Abstract Purpose Metronomic chemotherapy is defined as lower-dose, more frequent chemotherapy treatments. Herein, we report 14 consecutive patients with advanced non—small-cell lung cancer (NSCLC; 3 patients with stage IIIB disease, 11 patients with stage IV disease) who were treated between 2002 and current time with continuous weekly chemotherapy until disease progression or 1–2 cycles (12–24 weeks) beyond optimal response. Patients and Methods Patients with disease progression were treated with a salvage weekly chemotherapy regimen until progression. Since 2005, patients who had optimal response were placed on maintenance erlotinib. All patients had Eastern Cooperative Oncology Group performance status of 0–1, initiated first-line treatment at our clinic, and received ≥ 12 weeks of planned chemotherapy. Results All patients had a partial or complete response as their best response during the course of treatment. Median survival of this group of patients was > 30 months. One patient (patient 14) with bronchoalveolar lung cancer had a partial response (PR) in her lungs but developed brain metastasis that progressed soon after whole-brain radiation therapy. She was then placed on erlotinib and survived for 13 months. Another patient (patient 13) died of possible stroke while still in PR. Overall side effects from treatments were mild, with the most common side effects being grade 1/2 fatigue (75%) and peripheral neuropathy (40%), but no grade 3 or 4 neuropathy was observed. Conclusion Metronomic chemotherapy might be associated with long-term survival in patients with advanced NSCLC. Further clinical trials to confirm these findings are warranted.