Efficacy and safety of liposomal doxorubicin in a patient treated for metastatic breast cancer
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Liposomal doxorubicin is a newer form of chemotherapeutic agents that, due to its own special properties, preferably accumulates in cancer tissue. On the other hand, it shows lower affinity to cardiomyocytes and in this way is less cardiotoxic. As a result of that, there is the possibility to use liposomal form of doxorubicin until disease progression or chemotherapy intolerance in palliative setting, without treatment cessation after reaching the maximum cumulative dose of conventional doxorubicin. In this article we describe the case of a female patient diagnosed with breast cancer who was primary treated with adjuvant treatment, including chemotherapy and in whom a disease recurrence occurred after seven years of observation. As a primary palliative treatment the patient received chemotherapy based on liposomal doxorubicin and cyclofosphamide with a very good tolerance. The initial response was partial remission in lungs and in mediastinal lymph nodes. During the whole course of therapy there were no pathological changes in electrocardiogram, no signs and no symptoms of congestive heart failure, and the left ventricular ejection fraction was within normal limits.
- Jemal A, Siegel R, Wrad E et al. Cancer statistics, 2006. CA Cancer J Clin 2006; 56: 106-130.
- Wojciechowska U, Didkowska J. Zachorowania i zgony na nowotwory złośliwe w Polsce. Krajowy Rejestr Nowotworów, Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie [online: http://onkologia.org.pl/raporty].
- Slamon DJ, Leyland-Jones B, Shark S et al. Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 2001; 344: 783-792.
- Swain SM, Kim SB, Cortes J et al. Pertuzumab, trastuzumab, and docetaxel for HER2-positive metastatic breast cancer (CLEOPATRA study): overall survival results from a randomised, double-blind, placebo-controlled, phase 3 study. Lancet Oncol 2013; 14: 461-471.
- Cameron D, Casey M, Press M et al. A phase III randomized comparison of lapatinib plus capecitabine versus capecitabine alone in women with advanced breast cancer that has progressed on trastuzumab: updated efficacy and biomarker analyses. Breast Cancer Res Treat 2008; 112: 533-543.
- Yardley DA, Noguchi S, Pritchard KI et al. Everolimus plus exemestane in postmenopausal patients with HR(+) breast cancer: BOLERO-2 final progression-free survival analysis. Adv Ther 2013; 30: 870-884.
- Carbone PP. Chemotherapy in the treatment strategy of breast cancer. Cancer 1975; 36: 633-637.
- Clavarezza M, Venturini M. Adjuvant chemotherapy for the treatment of HER2-positive early breast cancer. Oncology 2009; 77(Suppl. 1): 14-17.
- Elias AD. Triple-negative breast cancer: a short review. Am J Clin Oncol 2010; 33: 637-645.
- Blum RH, Carter SK. Adriamycin. A new anticancer drug with significant clinical activity. Ann Intern Med 1974; 80: 249-259.
- Jones SE, Durie BG, Salmon SE. Combination chemotherapy with adriamycin and cyclophosphamide for advanced breast cancer. Cancer 1975; 36: 90-97.
- Buzdar AU, Marcus C, Smith TL et al. Early and delayed clinical cardiotoxicity of doxorubicin. Cancer 1985; 55: 2761-2765.
- Uziely B, Jeffers S, Isacson R et al. Liposomal doxorubicin: antitumor activity and unique toxicities during two complementary phase I studies. J Clin Oncol 1995; 13: 1777-1785.
- Swenson CE, Bolcsak LE, Batist G et al. Pharmacokinetics of doxorubicin administered i.v. as Myocet (TLC D-99; liposome-encapsulated doxorubicin citrate) compared with conventional doxorubicin when given in combination with cyclophosphamide in patients with metastatic breast cancer. Anticancer Drugs 2003; 14: 239-246.
- O’Brien ME, Wigler N, Inbar M et al. Reduced cardiotoxicity and comparable efficacy in a phase III trial of pegylated liposomal doxorubicin HCl (CAELYX/Dxil) versus conventional doxorubicin for first-line treatment of metastatic breast cancer. Ann Oncol 2004; 15: 440-449.
- Waterhouse DN, Tardi PG, Mayer LD, Bally MB. A comparison of liposomal formulations of doxorubicin with drug administered in free form: changing toxicity profiles. Drug Saf 2001; 24: 903-920.
- Park JW. Liposome-based drug delivery in breast cancer treatment. Breast Cancer Res 2002; 4: 95-99.
- [online: http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/000297/human_med_000916. jsp&mid=WC0b01ac058001d124].
- Slamon DJ, Leyland-Jones B, Shak S et al. Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2. N Engl J Med 2001; 344: 783-792.
- Anton A, Ruiz A, Plazaola A et al. Phase II clinical trial of liposomal-encapsulated doxorubicin citrate and docetaxel, associated with trastuzumab, as neoadjuvant treatment in stages II and IIIA HER2-overexpressing breast cancer patients. GEICAM 2003-03 study. Ann Oncol 2011; 22: 74-79.
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