Therapeutic Apheresis, Circulating PLD, and Mucocutaneous Toxicity: Our Clinical Experience through Four Years

Abstract

Cancer treatment has been greatly improved by the combined use of targeted therapies and novel biotechnological methods. Regarding the former, pegylated liposomal doxorubicin (PLD) has a preferential accumulation within cancer tumors, thus having lower toxicity on healthy cells. PLD has been implemented in the targeted treatment of sarcoma, ovarian, breast, and lung cancer. In comparison with conventional doxorubicin, PLD has lower cardiotoxicity and hematotoxicity; however, PLD can induce mucositis and palmo-plantar erythrodysesthesia (PPE, hand-foot syndrome), which limits its use. Therapeutical apheresis is a clinically proven solution against early PLD toxicity without hindering the efficacy of the treatment. The present review summarizes the pharmacokinetics and pharmacodynamics of PLD and the beneficial effects of extracorporeal apheresis on the incidence of PPE during chemoradiotherapy in cancer patients.

Utility of cooling patches to prevent hand-foot syndrome caused by pegylated liposomal doxorubicin in breast cancer patients

“…Plasma filtration can safely and effectively remove circulating PLD and decrease the incidence of HFS and mucositis[ 20 ]. However, the success rate depends on the technical equipment and experience of the operator in the therapeutic plasma filtration[ 2 ]. Topical antiperspirants (containing aluminum chlorohydrate) seemed to reduce the incidence of HFS, but the effect of preventing Grade 2 or Grade 3 HFS was insignificant (58%)[ 21 ].…”

“…Pegylated liposomal doxorubicin (PLD) is an effective chemotherapeutic drug commonly used in the treatment of breast cancer, ovarian cancer, lymphoma, and other malignant tumors. Hand-Foot Syndrome (HFS) and mucositis are the most common side effects of PLD treatment[ 2 ]. PLD is often administered in combination with other drugs, and patients may develop HFS after the treatment for 1-21 d or a few months, depending on the dose used[ 3 ].…”

Erratum: Filip, S.; et al. Therapeutic Apheresis, Circulating PLD, and Mucocutaneous Toxicity: Our Clinical Experience through Four Years. Pharmaceutics 2020, 12, 940

“…The following correction has been made to this paper [ 1 ]: We would like to inform the readers that our colleague, Jirina Martinkova, asked to be excluded as an author in this communication. Although we regret her decision, we have respectfully fulfilled her request and wish her the best in her future endeavors.…”