Pegylated liposomal doxorubicin as first-line monotherapy in elderly women with locally advanced or metastatic breast cancer: Novel treatment predictive factors identified

Bi-weekly liposomal doxorubicin for advanced breast cancer in elderly women (≥70years)

“…In the Swedish study a response rate of 13.6 was obtained, with a time to treatment failure (progression or toxicity leading to treatment interruption or death) of 5.5 months. 21 Two trials evaluated a first-line combination regimen of PLD plus vinorelbine in elderly patients, obtaining fairly good response rates of 36% 22 or 50%, 23 conflicting TTP of 4 months 22 or 8 months, 23 and higher rates of hematological toxicity (neutropenia 15% grade 3 and 11% grade 4) with 10% of febrile neutropenia, and gastro-intestinal toxicity. 23 The authors' conclusion that "the combination of PLD and vinorelbine is active and well tolerated in elderly patients" should be considered with caution since they applied an inferior age limit of 65 23 or even 60 years, 22 while 70 years is believed to be the real turning point for age related physiologic changes.…”

Autophagy and mitophagy in the context of doxorubicin-induced cardiotoxicity

“…Additionally, Dox cross-links Topoisomerase IIα (TOPIIα) to the DNA, forming a TOPIIα-Dox-DNA complex resulting in DNA breakage and cell death, a major mechanism for killing cancer cells which express high levels of TOPIIα [29–33]. Unlike tumor cells, cardiomyocytes do not express TOPIIα, rather they express topoisomerase IIβ (TOPIIβ) which can also form DNA-TOPIIβ-Dox complexes, cause double-strand breaks and cell death [34, 35].…”

A randomized phase III study comparing pegylated liposomal doxorubicin with capecitabine as first-line chemotherapy in elderly patients with metastatic breast cancer: results of the OMEGA study of the Dutch Breast Cancer Research Group BOOG

“…Anthracyclines and taxanes are effective agents in breast cancer, at the cost of myelotoxicity, alopecia and potential cardiotoxicity for anthracyclines and neuropathy for taxanes, respectively. Pegylated liposomal doxorubicin (PLD; Caelyx®; Janssen Cilag) and capecitabine (Xeloda®; Roche) appear to be effective and well tolerated in elderly cancer patients even with compromised condition [7,8].…”