DICER1 tumor predisposition syndrome: an evolving story initiated with the pleuropulmonary blastoma
Optimal Low-dose Metronomic Chemotherapy And Antiangiogenic Activity
Cite this articleKirby, R. Optimal low-dose metronomic chemotherapy and antiangiogenic activity. Nat Rev Clin Oncol 2, 489 (2005). Https://doi.Org/10.1038/ncponc0280
Share this article Get shareable linkMetronomics — Fulfilling Unmet Needs Beyond Level A Evidence
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Dr Shripad Banavali: Mumbai Heroes
Battling cancer and costsDr Shripad Banavali's research on an inexpensive treatment has given hope to thousands of poor patientsINITIATIVELow-cost cancer therapy
FACES BEHIND ITDr Shripad Banavali
NOMINATED FORResearch on an alternative treatment called metronomic therapy, which reduces the financial burden on TNBC patients to Rs 120-Rs 2,700 a month
Cancer treatment is expensive. Patients with triple-negative breast cancer, or TNBC, can end up with a monthly bill of Rs 50,000 after the first diagnosis and if they relapse, which happens in many cases, the figure can rise to over Rs 1.6 lakh a month. In 2016, Dr Shripad Banavali of Tata Memorial Hospital made an announcement which provided hope to thousands of people who don't have the resources to pursue costly treatments.
Dr Banavali, who heads the hospital's oncology department, shared the findings of his research on an alternative treatment called metronomic therapy, which reduces the financial burden on TNBC patients to Rs 120-Rs 2,700 a month and also promises to improve the survival rate. The treatment includes a combination of anti-diabetic and chemotherapy drugs that are not prohibitively expensive.
About 30 per cent of breast cancer patients are triple negative. This form of the disease affects younger women more and is hard to treat. A large number of the patients, around 45 per cent, relapse within three years and their survival chances reduce drastically.
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"There is not a lot doctors can do for such patients. Our study therefore sought to improve the first course of treatment and the results were tremendous," Dr Banavali said.
He added that 300 TNBC patients from Tata Memorial and its outreach facility, BKL Walawalkar Hospital in Devran, were put on the metronomic therapy and didn't show any signs of relapse after three years. The study began in 2008 and the findings were shared last year. They were reported in reputed journals around the world and also presented at the scientific conference organised by Tata Memorial in February last year. Experts from 23 countries attended the event.
Explaining the difference between the standard treatment and the alternative therapy, Dr Banavali said: "For the standard chemotherapy, we give Celecoxib 200 mg, a non-steroidal antiinflammatory medication; and cytotoxic chemotherapy drugs Cyclophosphamide 50 mg and Cisplatin isx 25mg. We only target the cancer. In the metronomic maintenance therapy, we decided to give a combination of three drugs Cyclophosphamide 50mg; Metformin 500mg, commonly used to treat Type 2 diabetes; and Methotexate 12 mg, also a cytotoxic chemotherapy drug. Metformin and Methotexate are low-cost medicines."
According to Dr Banavali, triplenegative breast cancer is affects many women in the age group of 35 to 45, and it is known to be more aggressive with a poor prognosis.
Dr Rakesh Jalali, a senior neurooncologist, said the research conducted by Dr Banavali had provided a lifeline to many people. "Doctors in developing countries like India have to focus on cost-effective treatments. At Tata Memorial, 90 per cent of patients are from poor and middle-income groups.Such unique studies will be a boon for thousands of cancer patients and we can improve their life," he said.
Dr Banavali said it was only a pilot project and more research was needed."But we have started this low-cost therapy for head and neck cancer patients. Over 1,000 people are undergoing this treatment," he said.
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