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Novel anthracyclines for breast cancer: efficacy and safety update
Dana-Farber Cancer Institute/Brigham and Women’s Cancer Center, Boston, MA
Anthracyclines are among the most active agents for breast cancer; however, the therapeutic index of these agents, particularly conventional doxorubicin, has limited their usage. In an effort to improve the safety and tolerability profile of conventional anthracyclines, research has focused on developing anthracycline analogs (eg, epirubicin) as well as liposomal formulations. Epirubicin has demonstrated efficacy in both the adjuvant and metastatic breast cancer settings. However, there are no convincing data showing that epirubicin is less cardiotoxic than doxorubicin. Pegylated liposomal doxorubicin has shown comparable efficacy and a significantly reduced risk of cardiac toxicity, when compared with the efficacy and cardiotoxicity of conventional doxorubicin, in patients with metastatic breast cancer. Pegylated liposomal doxorubicin is also effective and well tolerated as combination therapy with taxanes (paclitaxel and docetaxel), cyclophosphamide, and gemcitabine. In addition, studies suggest that pegylated liposomal doxorubicin may be safely combined with trastuzumab in patients with HER2-positive metastatic breast cancer. Indeed, novel anthracyclines have improved the therapeutic index of conventional doxorubicin.
| Commun Oncol 2005;2(suppl 1):8–16 | full text |  246 kb |