Efficacy of low-dose metronomic chemotherapy with 2 drugs versus 3 drugs oral regimen in metastatic breast cancer patients.

Objective: To investigate the effectiveness of two LDMC drugs (cyclophosphamide and methotrexate) compared to three drugs (cyclophosphamide, methotrexate, and capecitabine) in treating MBC. Study Design: Retrospective study. Period: September 21, 2021, and December 31, 2022. Setting: Oncology Unit, Nishtar Hospital Multan. Methods: This study involved 80 female patients with metastatic breast cancer (MBC) who were selected consecutively. The participants were divided into groups A and B, consisting of 40 patients. Group A received two oral LDMC medications, cyclophosphamide and methotrexate. In comparison, group B received three medications: cyclophosphamide, methotrexate, and capecitabine. Results: In the study, it was observed that 27.5% of participants in group A exhibited disease control rate, whereas 60% of patients in group B showed disease control rate (p=0.014). The mean progression free survival was 10.5 weeks in group A and 19.7 weeks in group B (p=0.039). The mean duration of response was 27.4 weeks in group A and 35.5 weeks in group B (p=0.412). Conclusion: This retrospective research has demonstrated that using the low-dose metronomic chemotherapy (LDMC) treatment with a three-medicine combination regimen significantly improved outcomes in patients with metastatic breast cancer (MBC). The observed disease control rate (DCR) was considerably higher.