Cancer Treatment Today

The proposed regimen is called metronomic chemotherapy.
Metronomic chemotherapy using a multidrug regimen was reported to be beneficial and well tolerated in patients with multiple myeloma that is highly refractory to previous treatments at ASCO 2012.1 Treatment was as follows:
Bortezomib (Velcade), 1 mg/m2 on days 1, 4, 7, 10, 13 and 16
Thalidomide (Thalomid), 200 mg on days 1 to 16
Dexamethasone, 2040 mg on days 1, 4, 7, 10, 13 and 16
Doxorubicin, 3 mg/m2 by continuous infusion on days 1 to 16
Cisplatin, 1.53 mg/m2 continuous infusion on days 1 to 16
Sirolimus (Rapamune), 3 mg on day 1, then 1 mg days 2 to 16 (depending on renal function)
The overall response rate was 65%, which included complete responses (6%), very good partial responses (7%), partial responses (36%), and minor responses (16%). Stable disease was achieved by 15% of the patients.

This regimen is not FDA approved and this concept is in trials in other cancer, though not in myeloma, and  More studies in myeloma should follow.

Many theoretical issues remain before metronomic chemotherapy can be routinely adopted. Currently, guidelines do not recommend it (http://www.medscape.com/viewarticle/726912_10).
1. Papanikolaou X, Szymonifka J, Rosenthal A, Heuck CJ, Mitchell A, Johann D, Jr, et al. Metronomic therapy is an effective salvage treatment for heavily pre-treated relapsed/refractory multiple myeloma. Haematologica. 2013;98(7):114753.
2. Hollmig K, Stover J, Talamo G, Fassas A, Lee C-K, Anaissie E, et al. Bortezomib (VelcadeTM) + AdriamycinTM + Thalidomide + Dexamethasone (VATD) as an Effective Regimen in Patients with Refractory or Relapsed Multiple Myeloma (MM). ASH Annual Meeting Abstracts. 2004;104:2399.
3.Eleftheria Hatzimichael and Evangelos Briasoulis, Metronomic chemotherapy beyond …Haematologica. Nov 2013; 98(11): e145