title: High cumulative doses of pegylated liposomal doxorubicin are not associated with cardiac toxicity in patients with gynecologic malignancies.
abstract: OBJECTIVE
  The purpose of this study was to determine the cardiac safety of pegylated liposomal doxorubicin (PLD) in patients receiving high cumulative doses of PLD.
  
  
  METHODS
  A retrospective chart review of women with gynecologic malignancies treated at Roswell Park Cancer Institute from 2002 through 2007 who received cumulative doses of PLD >or=400 mg/m(2) was performed.
  
  
  RESULTS
  Forty-two of 116 patients met the inclusion criteria. The mean age at initiation of PLD therapy was 63 years. The mean cumulative dose of PLD was 663.9 mg/m(2) (range 400-1,524 mg/m(2)). The mean cumulative number of cycles of PLD given was 9.8 (range 5-25). Multigated acquisition (MUGA) scans were obtained in 93% (39/42) of patients prior to or immediately following their first dose of PLD. The mean baseline ejection fraction was 63% (range 49-76%). Follow-up MUGA scans were performed on 7 patients (17%). Two of these patients had a decrease in their ejection fraction, but of only 3 and 1%. The remaining 5 patients who had follow-up MUGA scans had an average increase in their left ventricular ejection fraction of 4% (range 1-9%). No patients developed clinical evidence of congestive heart failure while being treated with PLD. There were no treatment interruptions or discontinuations due to cardiac toxicity.
  
  
  CONCLUSIONS
  Cumulative doses of PLD >or=400 mg/m(2) are not associated with clinically evident cardiac toxicity in gynecologic oncology patients.
authors.affiliation: Division of Gynecologic Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA.
authors.forename: Joshua P
authors.initials: JP
authors.lastname: Kesterson
authors.forename: Kunle
authors.initials: K
authors.lastname: Odunsi
authors.forename: Shashikant
authors.initials: S
authors.lastname: Lele
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D006321:Heart / Q000187:drug effects*; D006801:Humans; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D012189:Retrospective Studies
chemical_list: D000903:Antibiotics, Antineoplastic; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin
references.citation: Ann Oncol. 2007 Apr;18(4):716-21
references.pmid: 17301073
references.citation: Gynecol Oncol. 2001 May;81(2):206-12
references.pmid: 11330951
references.citation: Ann Oncol. 2000 Aug;11(8):1029-33
references.pmid: 11038041
references.citation: Semin Oncol. 2006 Feb;33(1):2-14
references.pmid: 16473642
references.citation: J Clin Oncol. 2008 Aug 1;26(22):3777-84
references.pmid: 18669466
references.citation: Gynecol Oncol. 2005 Jan;96(1):10-8
references.pmid: 15589573
references.citation: J Clin Oncol. 1997 Mar;15(3):987-93
references.pmid: 9060537
references.citation: J Clin Oncol. 2001 Jul 15;19(14):3312-22
references.pmid: 11454878
references.citation: Cancer. 2003 Jun 1;97(11):2869-79
references.pmid: 12767102
references.citation: Chemotherapy. 1993 Nov-Dec;39(6):410-5
references.pmid: 8222869
references.citation: Gynecol Oncol. 2001 Aug;82(2):323-8
references.pmid: 11531287
references.citation: Am J Med. 1987 Jun;82(6):1109-18
references.pmid: 3605130
references.citation: Chemotherapy. 1994 May-Jun;40(3):188-94
references.pmid: 8205937
references.citation: Cancer. 2004 May 15;100(10):2052-63
references.pmid: 15139046
references.citation: Gynecol Oncol. 2004 Jul;94(1):147-51
references.pmid: 15262133
references.citation: J Clin Oncol. 2000 Sep;18(17):3093-100
references.pmid: 10963637
references.citation: Ann Oncol. 2004 Mar;15(3):440-9
references.pmid: 14998846
references.citation: Oncol Res. 2008;17(2):51-8
references.pmid: 18543606
references.citation: Drug Saf. 2001;24(12):903-20
references.pmid: 11735647
references.citation: World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253
references.pmid: 11234459