Very few studies, often with very small cohortes, tended to prove chemotherapy efficiency against canine agressive mammary carcinomas, either on the metastasis or on the median survival of dogs after surgery and chemo, and this was not confirmed by other studies. As a result, we lack standardized efficient protocols that exist in human cases according to their grade and stage. In this case report of a relapsing grade III solid mammary carcinoma evolving into prominent lymphatic intravascular invasion with mutifocal nodal extension (stage 4), we applied an intensive treatment combining high dose surgery and intensive adjuvant chemotherapy. This adjuvant chemo combined a carboplatin maximal-tolerated-dose chemotherapy, with doses adjusted as necessary and a metronomic chemotherapy with firocoxib, toceranib and chloraminophen, progressively added together and carefully monitored. Adapting the doses allowed to avoid adverse events and to obtain 237 days of survival with good quality of life. To our knowledge, it is the first description of such a combination of treatment. That result should be confirmed by a prospective large-scale study.

Background: This retrospective study evaluates the survival effects of metronomic maintenance therapy with fluoropyrimidine in patients with stage III colorectal cancer (CRC) according to epidermal growth factor receptor (EGFR) expression. Methods: We enrolled 197 patients with stage III CRC who had undergone radical resection and FOLFOX regimen adjuvant chemotherapy. The clinicopathological features and effects of metronomic maintenance therapy on survival according to treatment group and EGFR expression were analyzed. By conducting an in vitro cell line study and in vivo study through knockdout of EGFR gene, we analyzed the capacities of cell proliferation and migration. Results: Postoperative relapse and mortality were significantly more common in the FOLFOX group. Metronomic maintenance therapy was a significantly independent predictive factor of postoperative relapse and mortality, as well as a prognostic factor of disease-free survival and overall survival. The significant differences of survival between the two groups were only observed in patients with positive EGFR expression. Conclusions: The present study suggested EGFR expression as the prognostic factor in patients with stage III CRC receiving metronomic maintenance therapy. By analyzing EGFR expression, we can identify the potential candidates with optimal survival benefit from metronomic maintenance therapy in patients with stage III CRC.

Background: This retrospective study evaluate the survival effects of metronomic maintenance therapy with fluoropyrimidine in patients with stage III colorectal cancer (CRC) according to epidermal growth factor receptor (EGFR) expression. Methods: We enrolled 197 patients with stage III CRC who had undergone radical resection and FOLFOX regimen adjuvant chemotherapy. The clinicopathological features and effects of metronomic maintenance therapy on survival according to treatment group and EGFR expression were analyzed. By conducting an in vitro cell line study and in vivo study through knockdout of EGFR gene, we analyzed the capacities of cell proliferation and migration. Results: Postoperative relapse and mortality were significantly more common in the FOLFOX group. Metronomic maintenance therapy was a significantly independent predictive factor of postoperative relapse and mortality, as well as a prognostic factor of disease-free survival and overall survival. We also demonstrated that EGFR-knockout Caco2 cells are more sensitive to the inhibition effect of fluoropyrimidine than the control those. Conclusions: The present study suggested EGFR expression as the prognostic factor in patients with stage III CRC receiving metronomic maintenance therapy. By analyzing EGFR expression and treatment strategies, we can identify the potential candidates with optimal survival benefit from metronomic maintenance therapy in patients with stage III CRC.

Background: The front-line treatment of advanced NeuroEndocrine Neoplasms (NENs) depends on clinical and pathological factors but there are no standard second-line therapies. Methods: Metastatic NENs patients were treated at the ENETS (European NeuroEndocrine Tumor Society) center of excellence of Naples (Italy), from 2014 to 2017 with second-line metronomic temozolomide, 75 mg/m2 per os “one week on/one week off”. Toxicity was graded with NCI-CTC criteria v4.0; objective responses with RECIST v1.1 and performance status (PS) according to ECOG. Results: Twenty-six consecutive patients were treated. Median age was 65.5 years. The predominant primary organs were pancreas and lung. Grading was G2 in 11 patients, G3 in 15. Eleven patients presented with PS 1 and 15 with PS 2. The median time-on-temozolomide therapy was 12.2 months (95% CI: 11.4-19.6). No G3/G4 toxicities were registered. Complete response was obtained in 1 patient, partial response in 4, stable disease in 19 (disease control rate: 92.3%), and progressive disease in 2. The median overall survival from temozolomide start was 28.3 months. PS improved in 73% of patients. Conclusions: Metronomic temozolomide is a safe and active treatment for G2 and G3 NENs. Prospective and larger trials are needed to confirm these results.

Background: Respiratory rehabilitation is a crucial component of cardiac recovery. This study primarily investigates the effectiveness of a novel respiratory rehabilitation technique known as Metronomic Breathing (MB) on cardiac recovery in post-PCI acute myocardial infarction (AMI) patients and compliance with home-based rehabilitation compared to traditional respiratory rehabilitation methods. Methods: From June 2022 to March 2023, 55 AMI patients admitted to the Shanghai Tenth People's Hospital Cardiovascular Department were consecutively enrolled. They were randomly divided into the MB and control groups, which underwent conventional abdominal breathing training. Afterwards, hemodynamic indicators and compliance with home-based rehabilitation were compared between the two groups. Results: After the intervention in the MB group, several cardiac functional parameters (SV, SVI, CO, CI, LCW, LCWI), myocardial contractility parameter (VI), and systemic vascular resistance parameters (SVR, SVRI) were significantly higher compared to the pre-intervention levels, with a significant difference (P < 0.05). Furthermore, post-treatment, the MB group exhibited higher values for SV, SVI, CO, CI, and VI, lower SVR, SVRI, and SBP and a lower readmission rate three months later than the control group. Moreover, the MB group displayed higher compliance with home-based cardiac rehabilitation (P < 0.05). Conclusions: Compared to conventional respiratory rehabilitation training methods, Metronomic respiratory therapy is more effective in the short term for reducing systemic vascular resistance, enhancing left ventricular ejection function, and increasing home-based rehabilitation compliance in patients following AMI with PCI.

Nasal tumors are one of the most common tumors in aged golden retrievers. Adenocarcinomas or carcinomas are diagnosed in the majority of nasal tumors. Radiation therapy is the first option to decrease the size of tumor, and oral or intravenous chemotherapy is administered depending on the prognosis. Therefore, it is important to select the most appropriate drug for chemotherapy considering the price and the presence of concurrent disease. Anticancer drugs include first-generation chemotherapies, second-generation targeted anticancer drugs, and third-generation immunotherapy drugs. Considering their price and effectiveness, first- or second-generation anticancer drugs are mainly used.We report a first case in which a retriever with a nasal tumor was successfully treated and managed using a metronomic combination of chlorambucil (4mg/day, SID) and prednisolone (10mg/day) orally for 9 months at a general practice. A 35 kg spayed female golden retriever aged 8 years and 8 months visited the Bundang New York Animal Hospital in July 2023. A protocol of 4 weeks of chemotherapy followed by 1 week of rest was repeated, and the nasal exudate was significantly reduced. The size of the nasal tumor was monitored using Computed Tomography (CT) imaging at a referral hospital, and the images were taken in the following order: 1. before radiation therapy at the referral hospital and before chemotherapy; 2. after radiation therapy and before chemotherapy; and 3. after radiation therapy and after chemotherapy. Since the first occurrence of epistaxis, 12 months have passed (as of July 24). The nasal exudate is barely visible, and the retriever’s vital signs and weight remain stable. The size of the nasal tumor significantly decreased after 9 months of chemotherapy without moderate side effects. This study demonstrates that a prednisolone/chlorambucil metronomic combination can be an alternative to kinase inhibitor drugs as it is the cheapest and most effective way to manage tumors along with conventional radiation therapy.