title: Metronomic administration of pegylated liposomal-doxorubicin in extensively pre-treated metastatic breast cancer patients: a mono-institutional case-series report.
abstract: BACKGROUND
  Metronomic chemotherapy has shown efficacy in patients with metastatic breast cancer. Pegylated liposomal-doxorubicin (PLD) pharmacokinetic characteristics support the rationale for using the drug in a metronomic fashion, potentially able to combine anthracyclines efficacy to a low toxicity profile.
  
  
  METHODS
  In a case-series report carried out in both anthracycline-naive and pre-treated metastatic breast cancer patients, we tested feasibility, clinical efficacy and tolerability of PLD administered with a novel metronomic schedule of 20mg/m(2) i.v. every two weeks.
  
  
  RESULTS
  52 patients were enrolled and 45 were evaluated. Forty-four patients were assessed for either response or toxicity. Eight patients (18%) had partial responses (PR) and 17 (39%) stable disease (SD), with a clinical benefit (CB) of 45% (95% CI: 30.3%-59.7%). Nineteen patients (43%) had progressive disease (PD). Neither grade 3 nor grade 4 haematological or clinical side effects were recorded, except for 2 patients with grade 3 palmar-plantar erythrodysesthesia (PPE). No cardiac toxicity was recorded.
  
  
  CONCLUSIONS
  Metronomic administration of PLD is a feasible and active treatment for extensively pre-treated metastatic breast cancer patients, alternative to classic anthracyclines, balancing clinical efficacy with a good quality of life in terms of reduced side effects and low personal costs for the patient.
authors.affiliation: Division of Medical Oncology, European Institute of Oncology, via Ripamonti 435, Milan, Italy. elisabetta.munzone@ieo.it
authors.forename: E
authors.initials: E
authors.lastname: Munzone
authors.forename: A
authors.initials: A
authors.lastname: Di Pietro
authors.forename: A
authors.initials: A
authors.lastname: Goldhirsch
authors.forename: I
authors.initials: I
authors.lastname: Minchella
authors.forename: E
authors.initials: E
authors.lastname: Verri
authors.forename: M
authors.initials: M
authors.lastname: Cossu Rocca
authors.forename: C
authors.initials: C
authors.lastname: Marenghi
authors.forename: G
authors.initials: G
authors.lastname: Curigliano
authors.forename: D
authors.initials: D
authors.lastname: Radice
authors.forename: L
authors.initials: L
authors.lastname: Adamoli
authors.forename: F
authors.initials: F
authors.lastname: Nolè
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010865:Pilot Projects; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011788:Quality of Life; D013997:Time Factors; D016387:Women's Health
chemical_list: D000903:Antibiotics, Antineoplastic; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin