Administration of liposomal doxorubicin in patients with metastatic breast cancer and significant concomitant cardiovascular conditions

A frequent dilemma faced by an oncologist about to take decision on a chemotherapeutic regime for patients with metastatic breast cancer is how to maintain balance between the expected treatment efficacy and predictable adverse events. In the case of anthracyclines what is problematic is their significant cardiotoxicity, in particular with reference to patients previously treated with them as part of adjuvant therapy. A relatively new method is replacement of conventional doxorubicin with its non-pegylated form, encapsulated in liposomes, which is capable of minimizing the side effects without compromising its therapeutic index. The present article discusses three cases of patients treated with non-pegylated liposomal doxorubicin (NPLD) as first-line chemotherapy administered for metastatic breast cancer. In all three cases considerable clinical improvement was observed, involving remission of pathological lesions and good quality of life.