Metronomic Chemotherapy in Pediatric Neurooncology: Insight the Problem. A Review

Metronomic chemotherapy (MCT) is a promising direction of anticancer therapy, as well as in pediatric oncology, and its administration in patients with refractory and recurrent tumors of the central nervous system becomes increasingly relevant. Being a regimen of low doses of antitumor agents with different mechanisms of action in a continuous mode for a long time, it allows to overcome the resistance of tumor cells and to minimize the toxic effects of treatment. Today, the issues of rational choice of MCT regimens, which are dependent on the type of tumor, and the application of biomarkers of its effectiveness, remain controversial. The article discusses in detail the biological effects of MCT with an accent on antiangiogenic one, as well as the possibilities and limitations of MCT application in pediatric practice and the results of studies in tumors of the central nervous system.