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OncoReview
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2015
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vol. 5
|
issue 1
A11-A15
EN
We describe a 62 year old female with metastatic HER-2-positive breast cancer, and with independent cardiovascular comorbidities. She was earlier treated with J131 therapy due to thyroid toxicity. She developed grade 2 mitral and tricuspid valvular insufficiency as a result of uncontrolled hypertension. In 2013, the patient was diagnosed with luminal B2 breast cancer with liver and bone metastases, and a large infiltration of the left breast together with the surrounding soft tissue. She was treated with liposomal doxorubicin and cyclophosphamide, with the dose of anthracycline slightly reduced to 50 mg/m2 because of the elevated liver enzymes. She was in complete remission during treatment, without any cardiac or hematologic toxicity. The treatment was prolonged to eight cycles until the liver tests returned to normal. The cumulative dose of liposomal doxorubicin amounted to 400 mg/m2 (with the maximum recommended dose of 600 mg/m2). We decided to administer the liposomal form of doxorubicin, which is less cardiotoxic than conventional doxorubicin, as first-line treatment in order to prevent cardiotoxicity in a patient who is a candidate for another cardiotoxic therapy involving trastuzumab in the future. The patient’s disease progressed 10 months following the completion of first-line therapy. There are no cardiologic contraindications to trastuzumab and there are no signs of liposomal doxorubicin-related cardiotoxicity or deterioration of the valvular insufficiency.
OncoReview
|
2015
|
vol. 5
|
issue 4
A151-154
EN
Breast cancer is the most common malignancy among women in Poland and all over the world. Despite the development of modern therapies, cytostatics still play one of the main roles in treatment of this disease. Classic anthracyclines, besides unquestionable efficacy in this disease, have a disadvantageous toxicity profile. Therefore, until now, there has been a limitation in using these drugs in patients with cardiological conditions and in patients who had previously taken anthracyclines. That was the cause for the development of a less toxic form of drug, which is liposomal doxorubicin – being as effective as classic anthracycline it has reduced cardiotoxicity. This article presents the case of a patient with metastatic breast cancer, in whom, after treatment with classic doxorubicin, liposomal form was administered which caused regression of liver metastases. Moreover, during treatment with liposomal doxorubicin, there has been no evidence of heart impairment.
OncoReview
|
2015
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vol. 5
|
issue 2
A67-70
EN
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.
OncoReview
|
2014
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vol. 4
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issue 4
A148-A154
EN
A frequent dilemma faced by an oncologist about to take decision on a chemotherapeutic regime for patients with metastatic breast cancer is how to maintain balance between the expected treatment efficacy and predictable adverse events. In the case of anthracyclines what is problematic is their significant cardiotoxicity, in particular with reference to patients previously treated with them as part of adjuvant therapy. A relatively new method is replacement of conventional doxorubicin with its non-pegylated form, encapsulated in liposomes, which is capable of minimizing the side effects without compromising its therapeutic index. The present article discusses three cases of patients treated with non-pegylated liposomal doxorubicin (NPLD) as first-line chemotherapy administered for metastatic breast cancer. In all three cases considerable clinical improvement was observed, involving remission of pathological lesions and good quality of life.
OncoReview
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2017
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vol. 7
|
issue 2
83-87
EN
Breast cancer is one of the most common malignancies across the world, including Poland. Chemotherapy plays an important part in the treatment of the disease. Most of the available chemotherapy drugs and regimens have undergone randomized clinical studies and have been registered for that specific indication. However, a number of drugs are used in an off-label manner, i.e. outside the officially approved product specifications. The paper discusses the use of several off-label therapies in breast cancer in order to demonstrate that such treatment may be well-grounded and indeed turns out beneficial in many cases. It describes the use of liposomal doxorubicin in pre- and post-operative treatment, capecitabine for incomplete efficacy of preoperative treatment, and the administration of metronomic vinorelbine. Moreover, the paper is aimed at demonstrating the legal basis and the principles of marketing authorization of off-label drug use.
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