Campos Susana
Dana-Farber Cancer Institute, Brigham and Women's Cancer Center, Boston, Massachusetts 02115, USA.
Oncologist. 2003;8 Suppl 2:10-6. doi: 10.1634/theoncologist.8-suppl_2-10.
Conventional anthracyclines, particularly doxorubicin, have played an important role in the treatment of patients with breast cancer for many decades. Conventional doxorubicin has shown excellent antitumor activity in the metastatic, neoadjuvant, and adjuvant settings. However, its clinical utility is limited due to acute and chronic toxicities, particularly cardiotoxicity, myelosuppression, nausea and vomiting, and alopecia. Liposomal doxorubicin formulations (liposomal doxorubicin [D-99] and pegylated liposomal doxorubicin) currently under investigation for the treatment of breast cancer have demonstrated similar efficacies and favorable toxicity profiles compared with conventional doxorubicin in patients with metastatic breast cancer. These agents have also shown efficacy and tolerability in several small studies as neoadjuvant therapy in patients with locally advanced breast cancer. While there are currently no studies with liposomal doxorubicin or pegylated liposomal doxorubicin as adjuvant therapy, their demonstrated activities and tolerabilities in the metastatic and neoadjuvant settings provide the rationale for the future study of these agents in adjuvant therapy for patients with early-stage breast cancer.
几十年来，传统蒽环类药物，尤其是多柔比星，在乳腺癌患者的治疗中发挥了重要作用。传统多柔比星在转移性、新辅助和辅助治疗中均显示出优异的抗肿瘤活性。然而，由于急性和慢性毒性，特别是心脏毒性、骨髓抑制、恶心呕吐和脱发，其临床应用受到限制。目前正在研究用于治疗乳腺癌的脂质体多柔比星制剂（脂质体多柔比星[D-99]和聚乙二醇化脂质体多柔比星），与传统多柔比星相比，在转移性乳腺癌患者中显示出相似的疗效和良好的毒性特征。在几项小型研究中，这些药物作为局部晚期乳腺癌患者的新辅助治疗也显示出疗效和耐受性。虽然目前尚无脂质体多柔比星或聚乙二醇化脂质体多柔比星作为辅助治疗的研究，但它们在转移性和新辅助治疗中的已证实活性和耐受性为未来在早期乳腺癌患者辅助治疗中研究这些药物提供了理论依据。
