Oral Metronomic Chemotherapy in Advanced and Metastatic Oral Squamous Cell Carcinoma: A Need of the Hour

Aim The present review article aims to compile the best available evidence-based data on oral metronomic chemotherapy (OMCT) including its mechanism of action, its utility, and future directions. Methods A systematic search was carried out in PubMed database for available English literature from las...

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Published in:Journal of maxillofacial and oral surgery 2024-08, Vol.23 (4), p.793-800
Main Authors: Kumar, Naveena A. N., Dikhit, Punit Singh, Jose, Anmi, Mehta, Vedant, Pai, Ananth, Kudva, Adarsh, Rao, Mahadev
Format: Article
Language:English
Subjects:
Antigens
Cancer therapies
Chemotherapy
Cytotoxicity
Dendritic cells
Dentistry
Dihydrofolate reductase
Drug dosages
Lymphatic system
Lymphocytes
Medicine
Medicine & Public Health
Metastasis
Observational studies
Oral and Maxillofacial Surgery
Oral cancer
Otorhinolaryngology
Plastic Surgery
Review Paper
Squamous cell carcinoma
Tumor necrosis factor-TNF
Vascular endothelial growth factor
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Summary:Aim The present review article aims to compile the best available evidence-based data on oral metronomic chemotherapy (OMCT) including its mechanism of action, its utility, and future directions. Methods A systematic search was carried out in PubMed database for available English literature from last 10 years between 2011 and 2021. Keyword combinations used were ‘Oral Metronomic chemotherapy for oral cancer, mechanism of action of OMCT, Oral metronomic chemotherapy in India, OMCT in recurrent and palliative treatment of oral cancers.’ Results Multitudes of studies have been published recently stating the role of OMCT in head and neck squamous cell carcinoma (HNSCC), but the studies with the category of level of evidence required to advocate OMCT as a recognized therapy are still scarce. On careful stratification of these studies, we found that OMCT has a lot to offer in palliative settings, recurrent, and metastatic HNSCC. There is some limited evidence of its role in adjuvant therapy as maintenance and in neoadjuvant setting. Conclusion With current evidence, there is a definite role of OMCT in treatment of oral SCC. OMCT can be an alternative in patients who are not tolerable or affordable for standard palliative chemotherapy and also an option for patient who are waiting for surgery. However, results of ongoing and future studies on exact mechanism, indications, and implications of this drug regimen would help in integration OMCT in current standard of therapy. Graphical abstract
ISSN:0972-8279
0974-942X
DOI:10.1007/s12663-023-01963-y