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Innovations in anthracycline therapy: overview
Department of Medicine, University of Mississippi Medical Center, Jackson, MS
Conventional anthracyclines have played a key role in the treatment of breast and ovarian cancer; however, their clinical utility has been somewhat limited by their toxicity. Acute toxicities include myelosuppression, nausea/vomiting, and alopecia. More importantly, conventional anthracyclines may cause irreversible myocardial damage, which limits retreatment and may compromise the quality of life of younger patients who are likely to live long after treatment is completed. In an effort to improve the therapeutic index of conventional anthracyclines, anthracycline analogs such as epirubicin have been developed and studied in breast and ovarian cancer, as well as other solid tumors and hematologic malignancies. Although epirubicin is effective in these cancers, studies have not shown a significant improvement in the risk of cardiotoxicity associated with epirubicin compared with conventional doxorubicin. Pegylated liposomal doxorubicin is a unique formulation that differs from conventional doxorubicin in its long plasma half-life, extended circulation time, and distribution throughout the body. Multiple studies demonstrate the efficacy and safety of pegylated liposomal doxorubicin in the treatment of breast and ovarian cancer. Moreover, pegylated liposomal doxorubicin has shown an improved toxicity profile compared with conventional doxorubicin, coupled with a significantly reduced risk of cardiotoxicity. Ongoing and future clinical trials will further define and extend the role of pegylated liposomal doxorubicin in the treatment of breast and ovarian cancer.
| Commun Oncol 2005;2(suppl 1):3–7 | full text |  165 kb |