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Novel anthracyclines for ovarian cancer: survival, tumor response, and tolerability
Department of Obstetrics and Gynecology, The University of Arizona, Phoenix, AZ
Anthracyclines had been a key component of ovarian cancer treatment in both the United States and Europe. Meta-analyses have revealed significant survival benefits with conventional doxorubicin in combination with cyclophosphamide and platinum, compared with cyclophosphamide/platinum therapy alone; however, concerns regarding the toxicity profile of conventional doxorubicin, particularly its cardiotoxicity, have limited its use. Studies of epirubicin, an anthracycline analog, in the treatment of ovarian cancer have failed to show a significant effect on survival and resulted in higher incidences of myelosuppression. Pegylated liposomal doxorubicin is an advanced formulation differing from conventional doxorubicin in its prolonged plasma half-life and in its volume of distribution. Studies have shown that pegylated liposomal doxorubicin has a superior toxicity profile compared with conventional doxorubicin, with a significantly reduced risk of cardiotoxicity. Phase II and III clinical studies support the use of pegylated liposomal doxorubicin as the first-choice non-platinum agent for patients with relapsed ovarian cancer, particularly following a recent report of an overall survival advantage for such patients who were treated initially with pegylated liposomal doxorubicin instead of topotecan. This survival advantage is pronounced in patients with platinum-sensitive disease and is similar to that observed with platinum-based therapy, suggesting a possible role for combination therapy with carboplatin and pegylated liposomal doxorubicin.
| Commun Oncol 2005;2(suppl 1):17–24 | full text |  238 kb |