Substituting Doxorubicin with Nonpegylated Liposomal Doxorubicin for the Treatment of Early Breast Cancer: Results of a Retrospective Study

Abstract

Introduction. Evidence from the metastatic setting suggests that replacing conventional doxorubicin with nonpegylated liposomal doxorubicin (NPLD) for early breast cancer may maintain efficacy whilst reducing long-term cardiotoxicity, an important consideration with many patients going on to receive multiple lines of treatment. Methods. Consecutive patients with early breast cancer treated with NPLD were assessed for disease progression and changes in cardiac function according to left ventricular ejection fraction (LVEF). Results. Ninety-seven patients (median age at diagnosis 51 (32–76) years) were studied. The majority received NPLD (60 mg/m2 plus cyclophosphamide 600 mg/m2) adjuvantly (79.4%) and in sequence with a taxane (79.4%; docetaxel 75 mg/m2). 80.4% had radiotherapy and 15.5% received trastuzumab. Mean time to disease recurrence was 87.0 months (80.7–93.2 [95% confidence interval]) and 5-year disease-free survival was 86.0%. Mean LVEF values remained within the normal range of ≥55% during treatment and throughout the cardiac follow-up period (median 7 months, range 1–21 months). Use of trastuzumab and age at diagnosis did not appear to influence LVEF. Conclusion. NPLD appeared to be a well-tolerated substitute for conventional doxorubicin in patients with early breast cancer.

Selective Activation of ZAK β Expression by 3-Hydroxy-2-Phenylchromone Inhibits Human Osteosarcoma Cells and Triggers Apoptosis via JNK Activation

“…Furthermore, we have also demonstrated that ZAKβ can enhance ZAKα expression in human OS cells, resulting in a synergistic apoptotic effect [16]. However, due to the adverse side effects associated with doxorubicin, various alternative drugs are under consideration [25,26]. Moreover, about 40%-45% of patients with high-grade osteosarcoma are either only partially responsive or completely unresponsive to doxorubicin (Dox), due to the increased drug efflux by the transporter protein ABCB1 [19].…”

Anthracyclines Strike Back: Rediscovering Non-Pegylated Liposomal Doxorubicin in Current Therapeutic Scenarios of Breast Cancer

“…It is important to underline that the majority of the patients enrolled presented with clinically high risk of relapse (59% Ki67 >14%, 50% stage III disease, with 72% node positive tumors, 26% triple negative breast cancer (TNBC), and 68% grade 3 tumors) [31]. Other retrospective experiences showed that replacing conventional anthracyclines with NPLD in (neo)adjuvant regimens including taxanes, produced similar results obtained with conventional anthracycline-containing regimens, with no specific cardiotoxicity concerns and otherwise comparable toxicity profiles [32,33].…”

Use of liposomal doxorubicin for adjuvant chemotherapy of breast cancer in clinical practice

“…By retrospective analysis, Davidson et al (2014) evaluated the effectiveness and safety of a combined NPLD regime for treating patients with early breast cancer. The results showed that five-year DFS rate of patients was up to 86% and the mean of left ventricular ejection fraction (LVEF) was still greater than 55%.…”