Key result
Nonpegylated liposomal doxorubicin is linked to ~86% 5-year disease-free survival while preserving LVEF.
Why the study?
Replacing conventional doxorubicin with nonpegylated liposomal doxorubicin for early breast cancer may maintain efficacy while reducing long-term cardiotoxicity, but evidence in this setting is limited.
Does substituting conventional doxorubicin with nonpegylated liposomal doxorubicin maintain efficacy and reduce cardiotoxicity in patients with early breast cancer?
Observational (n=97)
Does substituting conventional doxorubicin with nonpegylated liposomal doxorubicin maintain efficacy and reduce cardiotoxicity in patients with early breast cancer?
Nonpegylated liposomal doxorubicin appears to be a well-tolerated alternative to conventional doxorubicin in early breast cancer, maintaining normal LVEF without compromising oncologic efficacy.
May support NPLD in early breast cancer to limit cardiotoxicity; leaves open randomized confirmation of maintained efficacy.
Introduction. Evidence from the metastatic setting suggests that replacing conventional doxorubicin with nonpegylated liposomal doxorubicin (NPLD) for early breast cancer may maintain efficacy whilst reducing long-term cardiotoxicity, an important consideration with many patients going on to receive multiple lines of treatment. Methods. Consecutive patients with early breast cancer treated with NPLD were assessed for disease progression and changes in cardiac function according to left ventricular ejection fraction (LVEF). Results. Ninety-seven patients (median age at diagnosis 51 (32-76) years) were studied. The majority received NPLD (60 mg/m(2) plus cyclophosphamide 600 mg/m(2)) adjuvantly (79.4%) and in sequence with a taxane (79.4%; docetaxel 75 mg/m(2)). 80.4% had radiotherapy and 15.5% received trastuzumab. Mean time to disease recurrence was 87.0 months (80.7-93.2 [95% confidence interval]) and 5-year disease-free survival was 86.0%. Mean LVEF values remained within the normal range of ≥55% during treatment and throughout the cardiac follow-up period (median 7 months, range 1-21 months). Use of trastuzumab and age at diagnosis did not appear to influence LVEF. Conclusion. NPLD appeared to be a well-tolerated substitute for conventional doxorubicin in patients with early breast cancer.
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Davidson et al. (2014) conducted an observational in early breast cancer (n=97). Nonpegylated liposomal doxorubicin (NPLD) was evaluated on Disease progression and changes in cardiac function according to left ventricular ejection fraction (LVEF). Nonpegylated liposomal doxorubicin in early breast cancer yielded a 5-year disease-free survival of 86.0% and maintained mean LVEF ≥55% during a median 7-month cardiac follow-up.
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