title: Liposome-encapsulated doxorubicin citrate in previously treated recurrent/metastatic gynecological malignancies.
abstract: The aim of this study was to evaluate the safety and efficacy of liposome-encapsulated doxorubicin citrate (LEDC) in patients affected by recurrent/metastatic gynecological malignancies scheduled for palliative chemotherapy. Inclusion criteria were proven recurrent/advanced gynecological neoplasms, measurable/assessable disease, adequate organ function, left ventricular ejection fraction >50% as determined by echocardiography, informed consent. LEDC was administered intravenously over 1 h at the dose of either 75 mg/m(2) or 60 mg/m(2) (every 3 weeks until disease progression or toxicity prohibiting further therapy). From May 2003 to September 2005, 36 patients were enrolled. Primary disease was ovarian, endometrial, and cervical cancers in 15 (42%), 11 (30%), and 10 (28%) patients, respectively. LEDC was employed as third- or fourth-line chemotherapy in 25 (70%) and 11 (30%) patients, respectively. The median number of courses of LEDC received was 3 (range 2-9). Six patients (17%) achieved a partial response to treatment lasting 27 weeks and 10 patients (28%) experienced stable disease lasting 18 weeks. The predominant toxicity was hematological, especially neutropenia. Among patients receiving a dose of 75 mg/m(2), two (11%) suspended therapy for febrile neutropenia, and nine (50%) required a dose reduction of 25%. As a result, the next 18 patients were treated at a reduced dose (60 mg/m(2)) of LEDC. Severe neutropenia (G3-G4) was significantly less common in this group (61% versus 22%; P= 0.04). LEDC has shown antineoplastic activity in previously treated recurrent/metastatic gynecological cancer patients and the toxicity profile could be considered acceptable at a 60 mg/m(2) dosage.
authors.affiliation: Department of Obstetrics and Gynecology, University Campus Bio-Medico, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Angioli
authors.forename: I
authors.initials: I
authors.lastname: Palaia
authors.forename: M
authors.initials: M
authors.lastname: Calcagno
authors.forename: N
authors.initials: N
authors.lastname: Manci
authors.forename: M A
authors.initials: MA
authors.lastname: Zullo
authors.forename: F
authors.initials: F
authors.lastname: Bellati
authors.forename: G
authors.initials: G
authors.lastname: Perniola
authors.forename: A
authors.initials: A
authors.lastname: de Vivo
authors.forename: P
authors.initials: P
authors.lastname: Benedetti Panici
mesh_terms: D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D002951:Citrates / Q000009:adverse effects / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D010166:Palliative Care / Q000379:methods*
chemical_list: D000903:Antibiotics, Antineoplastic; D002951:Citrates; D004317:Doxorubicin