Abstract
Introduction: Pegylated liposomal doxorubicin (PLD) is considered to be the single-agent of first choice for patients with recurrent ovarian cancer following paclitaxel/carboplatin-based chemotherapy. However, this drug is associated with a local inflammatory tissue reaction, called palmoplantar erythrodysesthesia (PPE). A new liposomal formulation, known as Liposome Encapsulated Doxorubicin Citrate (LEDC), has been developed in the past decades to limit PPE. In this study we report our experience with LEDC in patients with recurrent ovarian cancer who discontinued doxil due to severe PPE. Methods: The present retrospective study included 43 patients with recurrent ovarian cancer who were treated with LEDC administered at the dose of 50 mg/mq every 3 weeks until disease progression or unacceptable toxicity. Toxicity was graded according to the National Cancer Institute Common Toxicity Criteria Version 3. Response was graded according to Response Evaluation Criteria in Solid Tumors (RECIST). Results: A total of 32 patients completed planned 6 cycles of chemotherapy. A complete response was achieved in 6%, partial response in 20%, stable disease in 37% and progression in 9% of patients. No cutaneous toxicity was reported. Conclusion: LEDC is a well tolerated drug and a valid therapeutic option for patients with ovarian cancer suffering from doxil-related cutaneous toxicity.
Highlights
Pegylated liposomal doxorubicin (PLD) is considered to be the single-agent of first choice for patients with recurrent ovarian cancer following paclitaxel/carboplatin-based chemotherapy
(one patient could have more than one side effects) etoposide (3), topotecan (4), gemcitabine (5) and pegylated liposomal doxorubicin (6) show response rate ranging from 9% to 33%, but prolonged remissions are uncommon
palmoplantar erythrodysesthesia (PPE) is an invalidating cutaneous toxicity reaction that severely reduces the quality of life of patients
Summary
Pegylated liposomal doxorubicin (PLD) is considered to be the single-agent of first choice for patients with recurrent ovarian cancer following paclitaxel/carboplatin-based chemotherapy. This drug is associated with a local inflammatory tissue reaction, called palmoplantar erythrodysesthesia (PPE). Patients with recurrent disease are commonly characterized as platinum sensitive or platinum resistant. The definition of platinum-resistant disease includes patients who progress while receiving initial chemotherapy or within 6 months of completing initial platinum-based chemotherapy. If platinum free interval is less than 3-month, patients are defined as refractory disease and they have very little chance to respond to a platinum-based therapy. Platinum-sensitive patients are defined by recurrence after 6 or more months of the completion of initial chemotherapy. Response to platinum retreatment increases with a longer interval from prior platinum treatment
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