Combination of pegylated liposomal doxorubicin (PLD) and paclitaxel in patients with advanced soft tissue sarcoma: a phase II study of the Hellenic Cooperative Oncology Group

Bafaloukos, Dimitrios; Papadimitriou, C.; Linardou, Helena; Aravantinos, G.; Papakostas, Pavlos; Skarlos, D.; Kosmidis, P.; Fountzilas, George; Gogas, Helen; Kalofonos, C.; Dimopoulos, Meletios Α.

doi:10.1038/sj.bjc.6602148

Cited by 18 publications

(10 citation statements)

References 34 publications

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“…Adverse cutaneous reactions associated with paclitaxel treatment include bullous fixed drug eruption (2), erythema multiforme (3), pustular eruption (4), scleroderma-like cutaneous lesions (5), onycholysis (6), and acral erythema (one case) (7). Of note, acral erythema (erythrodysesthesia) has been reported with multi-drug chemotherapy protocols that included paclitaxel (8,9). We report here the first case of paclitaxel-induced neutrophilic adverse reaction with concomitant acral erythema, and highlight the mechanisms that may be involved.…”

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confidence: 96%

Paclitaxel-induced Neutrophilic Adverse Reaction and Acral Erythema

Cruz¹,

Temu²,

Hines-Telang³

et al. 2011

Acta Derm Venerol

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Paclitaxel, a microtubule-stabilizing anti-neoplastic agent that belongs to the family of taxanes, is used in the treatment of advanced and/or refractory lung, breast, head, neck and other epithelial cancers. Site-specific reactions, such as inflammation at injection sites or cellulitis after extravasation ( 1 ), have been reported. Adverse cutaneous reactions associated with paclitaxel treatment include bullous fixed drug eruption (2), erythema multiforme (3), pustular eruption (4), scleroderma-like cutaneous lesions (5), onycholysis (6), and acral erythema (one case) (7). Of note, acral erythema (erythrodysesthesia) has been reported with multi-drug chemotherapy protocols that included paclitaxel (8,9). We report here the first case of paclitaxel-induced neutrophilic adverse reaction with concomitant acral erythema, and highlight the mechanisms that may be involved. CASE REPORTA 77-year-old Caucasian woman undergoing chemotherapy for breast cancer presented with mildly sensitive skin lesions on the dorsal hands and painful lesions on the lower extremities. She had been treated with weekly intravenous paclitaxel for 3 months, and the skin lesions were noticed after the second cycle of the drug, flared after each subsequent dose of the medication. There was no history of fever or other systemic symptoms, and no prior trauma to the extremities. The treatment protocol involved premedication with diphenhydramine and ranitidine 3 h prior to receiving paclitaxel. Other medications during this period were alendronate sodium, levothyroxine, vitamin D and aspirin. The patient had been taking these medications for several years prior to paclitaxel exposure and continued taking them after the skin lesions resolved. Physical examination revealed erythematous, mildly edematous, tender papules and plaques on the dorsal hands ( Fig. la), palms, dorsal feet and soles, as well as multiple, tender, erythematous, dusky red or violaceous papules and plaques symmetrically on the lower extremities (Fig. lb).Biopsy specimens from the left leg demonstrated hyperkeratosis, acanthosis, spongiosis, dyskeratosis with occasional satellite cell necrosis, and a moderately dense predominantly neutrophilic infiltrate (Fig. 2). Stains for microorganisms (Gram and Giemsa) were negative. Complete blood cell count and differential, urinalysis, electrolytes, liver function tests, serum protein electrophoresis, hepatitis sérologies and autoantibody profile (antinuclear, SSA, SSB and anti-neutrophic cytoplasmic antibodies) were within normal limits. Treatment with clobetasol 0.05% cream was not helpful. The lesions on the legs resolved spontaneously over the course of several weeks after the last cycle of paclitaxel.

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mentioning

confidence: 96%

Paclitaxel-induced Neutrophilic Adverse Reaction and Acral Erythema

Cruz¹,

Temu²,

Hines-Telang³

et al. 2011

Acta Derm Venerol

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“…It is becoming increasingly appreciated that stabilization of disease is a realistic end point for metastatic STS, as therapeutic agents that produce a low objective antitumour response may still slow tumour progression and prolong survival. It has further been shown that survival in patients with a stable disease is comparable with that in patients with partial or complete response [14].…”

Section: Discussionmentioning

confidence: 96%

Long-term response to pegylated liposomal doxorubicin in patients with metastatic soft tissue sarcomas

Grenader¹,

Goldberg²,

Hadas-Halperin³

et al. 2009

Anti-Cancer Drugs

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Doxorubicin and ifosfamide are currently considered the cornerstones of treatment for advanced soft tissue sarcomas (STSs). Pegylated liposomal doxorubicin (PLD) has been shown to have equivalent activity to doxorubicin and an improved toxicity profile. A review of the medical records of 11 patients with a variety of STSs treated with PLD was performed. The median age of the patients was 54.8 years. Of the 11 patients, seven received no earlier systemic therapy for their sarcoma. The initial dose per course was 40-60 mg/m2 every 4 weeks with dose reduction to 40 mg/m2 in the second or third cycle. A median of 11 cycles was given (range, two to 29 cycles). Treatment was generally well tolerated. We did observe some toxic effects as described earlier with PLD, including mild myelosuppression, skin toxicity and fatigue. No cardiotoxicity was observed. Of the 11 treated patients, six had a partial response, two had a best response of stable disease and three had progressive disease. All six patients with a partial response had an extended time to progression. To date, two patients continue on treatment (15 and seven cycles); one patient has stable disease 60 months after withdrawal of PLD (after eight cycles) and one patient had progression of disease 7 months after the withdrawal of therapy after 20 cycles. Of the two patients with stabilization of their disease, one had progression after 29 months and one continues on treatment for 6 months. PLD is active and safe for long-term treatment of metastatic STSs and may be important in maintaining response.

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“…Both Kaposi's sarcoma and angiosarcoma are tumors of the endothelial cells and may share some biological properties 10 . Recently, paclitaxel combined with liposomal doxorubicin has also been reported to demonstrate favorable results in the treatment of angiosarcoma 11 . Even though the overall response is poor with chemotherapy, patients treated with chemotherapy had better survival outcomes than did those without chemotherapy 12 .…”

Section: Discussionmentioning

confidence: 99%

Primary Angiosarcoma of Pericardium with Cardiac Tamponade: A Case Report

Chen

et al. 2015

International Journal of Gerontology

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Combination of pegylated liposomal doxorubicin (PLD) and paclitaxel in patients with advanced soft tissue sarcoma: a phase II study of the Hellenic Cooperative Oncology Group

Cited by 18 publications

References 34 publications

Paclitaxel-induced Neutrophilic Adverse Reaction and Acral Erythema

Paclitaxel-induced Neutrophilic Adverse Reaction and Acral Erythema

Long-term response to pegylated liposomal doxorubicin in patients with metastatic soft tissue sarcomas

Primary Angiosarcoma of Pericardium with Cardiac Tamponade: A Case Report

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