Livi Lorenzo, Meattini Icro, Cardillo Carla De Luca, Mangoni Monica, Greto Daniela, Petrucci Alessia, Rampini Andrea, Bruni Alessio, Galardi Alessandra, Cataliotti Luigi, Biti Giampaolo
Department of Radiotherapy-Oncology, University of Florence, Florence, Italy.
Tumori. 2009 Jul-Aug;95(4):422-6. doi: 10.1177/030089160909500402.
Anthracyclines such as doxorubicin play a central role in the management of advanced breast cancer. Unfortunately, the clinical benefits of anthracyclines are limited by cardiotoxicity that can lead to the development of potentially fatal congestive heart failure. In order to limit anthracycline-related cardiotoxicity, liposomal formulations of doxorubicin have been developed. This retrospective analysis evaluated the experience obtained with non-pegylated liposomal doxorubicin as first-line therapy in 34 patients with metastatic breast cancer.
Patients received non-pegylated liposomal doxorubicin in combination with either cyclophosphamide (n = 14) or docetaxel (n = 20) for up to eight cycles, and efficacy and safety were assessed according to standard criteria.
The overall response rate was 71%. The median progression-free survival was 8 months in patients receiving non-pegylated liposomal doxorubicin plus cyclophosphamide and 13.8 months in those receiving non-pegylated liposomal doxorubicin plus docetaxel (P = 0.2). The most commonly observed toxicities were grade 1-2 leucopenia, alopecia, nausea and vomiting; no grade 3-4 toxicities were observed. Overall, three patients (9%) experienced grade 1 cardiac toxicity.
Our results support the use of non-pegylated liposomal doxorubicin as an alternative to conventional doxorubicin formulations in combination regimens for the first-line therapy of metastatic breast cancer.
阿霉素等蒽环类药物在晚期乳腺癌的治疗中发挥着核心作用。不幸的是,蒽环类药物的临床益处受到心脏毒性的限制,心脏毒性可导致潜在致命性充血性心力衰竭的发生。为了限制蒽环类药物相关的心脏毒性,已开发出阿霉素的脂质体制剂。本回顾性分析评估了34例转移性乳腺癌患者使用非聚乙二醇化脂质体阿霉素作为一线治疗的经验。
患者接受非聚乙二醇化脂质体阿霉素联合环磷酰胺(n = 14)或多西他赛(n = 20)治疗,最多8个周期,并根据标准标准评估疗效和安全性。
总缓解率为71%。接受非聚乙二醇化脂质体阿霉素加环磷酰胺治疗的患者中位无进展生存期为8个月,接受非聚乙二醇化脂质体阿霉素加多西他赛治疗的患者为13.8个月(P = 0.2)。最常观察到的毒性为1-2级白细胞减少、脱发、恶心和呕吐;未观察到3-4级毒性。总体而言,3例患者(9%)出现1级心脏毒性。
我们的结果支持在转移性乳腺癌一线治疗的联合方案中,使用非聚乙二醇化脂质体阿霉素替代传统阿霉素制剂。