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

Abstract

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.

Long-term cure of soft tissue sarcoma with pegylated-liposomal doxorubicin after doxorubicin and ifosfamide failure

“…Unlike doxorubicin, PLD’s uptake by the reticuloendothelial system is decreased, resulting in different pharmacologic properties, including a longer half-life in blood and different toxicities [7–10]. PLD is associated with less cardiotoxicity, nausea, alopecia, and myelosuppression than free doxorubicin; this reduced toxicity obviates the need for premedication [6, 9–14]. PLD’s main toxicities are hand-foot syndrome, low risk of infusion reaction, and some fatigue [6, 9–11, 13, 14].…”

Current nonsurgical treatment options and concepts for soft tissue sarcoma in adults

“…Liposomal doxorubicin was proven also to be effective with a lower toxicity-profile than doxorubicin [42,43].…”

The role of Pazopanib in Soft Tissue Sarcoma: A comprehensive review of the literature

“…Some series report durable RRs up to 50% in many patients [15]. It is an agent used for metastatic STS, most commonly in Europe and in patients older than 65 years.…”