Necessity of routine cardiac evaluation in patients receiving pegylated liposomal doxorubicin for gynecologic cancer

Dioun, Shayan; Vilardo, Nicole; Goldberg, Gary L.; Gressel, Gregory M.

doi:10.1016/j.ygyno.2019.09.009

Cited by 5 publications

(7 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…29 Even though there was no significant difference in grade ≥3 heart failure between the 2 groups in our meta-analysis, routine cardiac evaluation in HER2-negative breast cancer patients receiving bevacizumab-containing neoadjuvant chemotherapy is necessary. 24,30,31 Another grade ≥3 adverse event that requires monitoring is proteinuria. However, no statistically significant difference was observed after adding bevacizumab to neoadjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Comparative Toxicities of Neoadjuvant Chemotherapy With or Without Bevacizumab in HER2-Negative Breast Cancer Patients: A Meta-analysis

Wang

Xie

et al. 2019

Ann Pharmacother

View full text Add to dashboard Cite

Background: The addition of bevacizumab to neoadjuvant chemotherapy improves the pathological complete response rate of human epidermal growth factor 2 (HER2)-negative breast cancer patients. However, the characteristics of adverse events associated with the use of bevacizumab should receive more attention from clinicians. Objective: This meta-analysis aimed to detect the adverse events of adding bevacizumab to neoadjuvant chemotherapy compared with neoadjuvant chemotherapy alone in HER2-negative breast cancer patients. Methods: PubMed, Cochrane Library, Web of Science, and EMBASE databases were systematically accessed to find eligible studies from January 1, 2000, to October 20, 2019. Reference lists were searched for additional studies. Pooled risk ratios for adverse events of bevacizumab were meta-analyzed. Results: Overall, 6 of 829 initially identified studies met the inclusion criteria, with 4681 patients randomized (2321 in the bevacizumab plus neoadjuvant chemotherapy group and 2360 in the neoadjuvant chemotherapy group). The incidence of grade ≥3 hypertension, left-ventricular dysfunction, mucositis, febrile neutropenia, infection, pain, hand-foot syndrome, hemorrhage, and neutropenia significantly increased in patients treated with bevacizumab plus neoadjuvant chemotherapy. However, adding bevacizumab to neoadjuvant chemotherapy was not associated with increasing the incidences of grade ≥3 proteinuria, dyspnea, heart failure, peripheral neurotoxicity, thrombosis, thrombocytopenia, fatigue, leucopenia, vomiting, nausea, and diarrhea. Conclusion and Relevance: Adding bevacizumab to neoadjuvant chemotherapy to treat HER2-negative breast cancer patients increased adverse events. However, most adverse events are clinically manageable. Patients, therefore, need to be monitored carefully for hypertension, left-ventricular dysfunction, mucositis, febrile neutropenia, infection, pain, hand-foot syndrome, hemorrhage, and neutropenia when treated with bevacizumab and neoadjuvant chemotherapy simultaneously.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparative Toxicities of Neoadjuvant Chemotherapy With or Without Bevacizumab in HER2-Negative Breast Cancer Patients: A Meta-analysis

Wang

Xie

et al. 2019

Ann Pharmacother

View full text Add to dashboard Cite

show abstract

“…In a clinical study of female patients with advanced breast cancer, patients who received PLD at a cumulative dose of 450-550 mg/m 2 had an 11% risk of cardiotoxicity. For ovarian cancer, the high cumulative dose of PLD exceeds the total lifetime cumulative dose of 550 mg/m 2 initially recommended by FDA, but there is a lack of evidence to support the standard practice guidelines for these patients [12]. Compared with the general population, the cardiovascular mortality of female patients with breast cancer is increased, and the risk is about twice as high when considering age, menopausal status, and other typical risks [15].…”

Section: Womenmentioning

confidence: 99%

“…Second, PEG macromolecule reduces the interaction between liposomes and blood component including opsonins and macrophages, maintains the liposome shape before Dox enters the tumor, and prolongs the circulation time of Dox. PEGylated coating of PLD forms a hydrophilic barrier protecting the liposomes from reticuloendothelial system detection and prolong the half-life of drugs in vivo [ 12 ]. Therefore, PLD leaves blood vessels much slower than Dox [ 13 –, 14 – 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…In a clinical study of female patients with advanced breast cancer, patients who received PLD at a cumulative dose of 450–550 mg/m 2 had an 11% risk of cardiotoxicity. For ovarian cancer, the high cumulative dose of PLD exceeds the total lifetime cumulative dose of 550 mg/m 2 initially recommended by FDA, but there is a lack of evidence to support the standard practice guidelines for these patients [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…FDA recommends routine assessment of LVEF by multi-gated radionuclide angiography (MUGA) or echocardiography before, during, and after PLD treatment [ 12 ]. The decrease in LVEF is regarded as a biomarker that is related to heart failure or can predict the development of heart failure [ 50 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cardiac safety analysis of first-line chemotherapy drug pegylated liposomal doxorubicin in ovarian cancer

Cheng

Zhang

et al. 2022

J Ovarian Res

View full text Add to dashboard Cite

Pegylated liposomal doxorubicin (PLD) is a nano-doxorubicin anticancer agent. It was used as early as 2014 to treat ovarian and breast cancer, multiple myeloma and Kaposi's sarcoma. The 2018 National Comprehensive Cancer Network guidelines listed PLD as first-line chemotherapy for ovarian cancer. PLD has significant anticancer efficacy and good tolerance. Although PLD significantly reduces the cardiotoxicity of conventional doxorubicin, its cumulative-dose cardiotoxicity remains a clinical concern. This study summarizes the high-risk factors for PLD-induced cardiotoxicity, clinical dose thresholds, and cardiac function testing modalities. For patients with advanced, refractory, and recurrent malignant tumors, the use of PLD is still one of the most effective strategies in the absence of evidence of high risk such as cardiac dysfunction, and the lifetime treatment dose should be unlimited. Of course, they should also be comprehensively evaluated in combination with the high-risk factors of the patients themselves and indicators of cardiac function. This review can help guide better clinical use of PLD.

show abstract

The application strategy of liposomes in organ targeting therapy

Xun,

Li,

Xue

2024

WIREs Nanomed Nanobiotechnol

View full text Add to dashboard Cite

Liposomes—microscopic phospholipid bubbles with bilayered membrane structure—have been a focal point in drug delivery research for the past 30 years. Current liposomes possess a blend of biocompatibility, drug loading efficiency, prolonged circulation and targeted delivery. Tailored liposomes, varying in size, charge, lipid composition, and ratio, have been developed to address diseases in specific organs, thereby enhancing drug circulation, accumulation at lesion sites, intracellular delivery, and treatment efficacy for various organ‐specific diseases. For further successful development of this field, this review summarized liposomal strategies for targeting different organs in series of major human diseases, including widely studied cardiovascular diseases, liver and spleen immune diseases, chronic or acute kidney injury, neurodegenerative diseases, and organ‐specific tumors. It highlights recent advances of liposome‐mediated therapeutic agent delivery for disease intervention and organ rehabilitation, offering practical guidelines for designing organ‐targeted liposomes.This article is categorized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Biology‐Inspired Nanomaterials > Lipid‐Based Structures

show abstract

Necessity of routine cardiac evaluation in patients receiving pegylated liposomal doxorubicin for gynecologic cancer

Cited by 5 publications

References 13 publications

Comparative Toxicities of Neoadjuvant Chemotherapy With or Without Bevacizumab in HER2-Negative Breast Cancer Patients: A Meta-analysis

Comparative Toxicities of Neoadjuvant Chemotherapy With or Without Bevacizumab in HER2-Negative Breast Cancer Patients: A Meta-analysis

Cardiac safety analysis of first-line chemotherapy drug pegylated liposomal doxorubicin in ovarian cancer

The application strategy of liposomes in organ targeting therapy

Contact Info

Product

Resources

About