Carlo Palmieri1, Vivek Misra2, Adam Januszewski3, Hosney Yosef4, Richard Ashford5, Ian Keary6, Neville Davidson7. 1. Department of Medical Oncology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom; Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom; Liverpool and Merseyside Academic Unit, Cancer Services, Royal Liverpool University Hospital, Liverpool, United Kingdom; Academic Department of Medical Oncology, Clatterbridge Cancer Centre NHS Foundation Trust, Wirral, United Kingdom. Electronic address: c.palmieri@liverpool.ac.uk. 2. The Christie NHS Foundation Trust, Manchester, United Kingdom. 3. Department of Medical Oncology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom. 4. The Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom. 5. Mount Vernon Cancer Centre, Northwood, Middlesex, United Kingdom. 6. Strategen Limited, Basingstoke, United Kingdom. 7. Helen Rollason Cancer Charity, Chelmsford, Essex, United Kingdom.
Abstract
BACKGROUND: This study aimed to investigate the use of nonpegylated liposomal doxorubicin (NPLD) in the management of metastatic breast cancer (MBC) within routine UK clinical practice and to assess its efficacy and tolerability. PATIENTS AND METHODS: All patients that received NPLD for MBC at 5 institutions were identified. Clinicopathologic details, echocardiographic data, and toxicities were documented. Response to treatment, outcome, cardiotoxicity, and safety were assessed. RESULTS: 63 patients (median age at NPLD therapy, 53.5 years) who had received NPLD were identified; 18 (29%) were anthracycline-naïve, and 42 (67%) were anthracycline-pretreated (median cumulative dose of epirubicin, 450 mg/m(2)). In 3 cases, prior treatment history was not available. NPLD was most frequently (16 [25%] of 63 patients) administered as first-line chemotherapy (median, third-line; range, 1-9), although it was given later in anthracycline-pretreated patients (median, fourth-line; range, 1-9). Overall, 14 (29%) of 49 evaluable patients achieved an objective response, which increased to 10 (71%) of 14 when NPLD was given first-line (anthracycline-naïve, 8 [100%] of 8; anthracycline-pretreated, 2 [50%] of 4; adjuvant treatment unknown, 2). Median progression-free survival was 7 months (first-line, 18 months, vs. ≥ second-line, 6 months; P = .0066), and median overall survival was 10 months (first-line, 18 months, vs. ≥ second-line, 10 months; P = .0971). Toxicities tended to be grade 1 or 2. Three patients had cardiotoxicity (left ventricular ejection fraction < 50% or a fall of ≥ 10% from baseline), which resolved during treatment. CONCLUSION: NPLD was used in both anthracycline-naïve patients and those with prior exposure. There is evidence of clinical activity in those with prior exposure to anthracyclines, with a low incidence of cardiotoxicity.
BACKGROUND: This study aimed to investigate the use of nonpegylated liposomal doxorubicin (NPLD) in the management of metastatic breast cancer (MBC) within routine UK clinical practice and to assess its efficacy and tolerability. PATIENTS AND METHODS: All patients that received NPLD for MBC at 5 institutions were identified. Clinicopathologic details, echocardiographic data, and toxicities were documented. Response to treatment, outcome, cardiotoxicity, and safety were assessed. RESULTS: 63 patients (median age at NPLD therapy, 53.5 years) who had received NPLD were identified; 18 (29%) were anthracycline-naïve, and 42 (67%) were anthracycline-pretreated (median cumulative dose of epirubicin, 450 mg/m(2)). In 3 cases, prior treatment history was not available. NPLD was most frequently (16 [25%] of 63 patients) administered as first-line chemotherapy (median, third-line; range, 1-9), although it was given later in anthracycline-pretreated patients (median, fourth-line; range, 1-9). Overall, 14 (29%) of 49 evaluable patients achieved an objective response, which increased to 10 (71%) of 14 when NPLD was given first-line (anthracycline-naïve, 8 [100%] of 8; anthracycline-pretreated, 2 [50%] of 4; adjuvant treatment unknown, 2). Median progression-free survival was 7 months (first-line, 18 months, vs. ≥ second-line, 6 months; P = .0066), and median overall survival was 10 months (first-line, 18 months, vs. ≥ second-line, 10 months; P = .0971). Toxicities tended to be grade 1 or 2. Three patients had cardiotoxicity (left ventricular ejection fraction < 50% or a fall of ≥ 10% from baseline), which resolved during treatment. CONCLUSION: NPLD was used in both anthracycline-naïve patients and those with prior exposure. There is evidence of clinical activity in those with prior exposure to anthracyclines, with a low incidence of cardiotoxicity.
Authors: Diwakar Jain; Raymond R Russell; Ronald G Schwartz; Gurusher S Panjrath; Wilbert Aronow Journal: Curr Cardiol Rep Date: 2017-05 Impact factor: 2.931
Authors: Christian Schmidt; Fabiano Yokaichiya; Nurdan Doğangüzel; Margareth K K Dias Franco; Leide P Cavalcanti; Mark A Brown; Melissa I Alkschbirs; Daniele R de Araujo; Mont Kumpugdee-Vollrath; Joachim Storsberg Journal: Biomedicines Date: 2016-09-15