%0 Journal Article
%T Substituting Doxorubicin with Nonpegylated Liposomal Doxorubicin for the Treatment of Early Breast Cancer: Results of a Retrospective Study
%A Neville Davidson
%A Teresa Camburn
%A Ian Keary
%A David Houghton
%J International Journal of Breast Cancer
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/984067
%X 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¨C76) years) were studied. The majority received NPLD (60£¿mg/m2 plus cyclophosphamide 600£¿mg/m2) adjuvantly (79.4%) and in sequence with a taxane (79.4%; docetaxel 75£¿mg/m2). 80.4% had radiotherapy and 15.5% received trastuzumab. Mean time to disease recurrence was 87.0 months (80.7¨C93.2 [95% confidence interval]) and 5-year disease-free survival was 86.0%. Mean LVEF values remained within the normal range of ¡Ý55% during treatment and throughout the cardiac follow-up period (median 7 months, range 1¨C21 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. 1. Introduction Nonpegylated liposomal doxorubicin (NPLD; Myocet, Teva UK) has potential advantages over conventional doxorubicin in the treatment of early breast cancer. Utilising a less cardiotoxic but equally effective treatment earlier in management may help to maximise therapeutic options later in the course of disease and thereby facilitate the use of multiple lines of therapy. In addition, substituting NPLD for doxorubicin as the standard anthracycline in early breast cancer may help address the growing concerns regarding the longer-term impact of treatment on cardiac function, a key survivorship issue [1, 2]. However, whilst NPLD has been extensively studied in metastatic breast cancer and is licensed in this regard [3¨C7], data on its use in early disease are currently scarce [8, 9]. As advances in diagnosis, management, and treatment have led to improved breast cancer survival, the issue of longer-term, therapy-related cardiotoxicity has taken on increasing importance, with patients potentially facing multiple, coincident insults to the heart [10]. Many of the available adjuvant therapies, which are increasingly used in combination or sequence, have been associated with some form of cardiotoxicity during or after therapy, whilst increasing age, comorbid
%U http://www.hindawi.com/journals/ijbc/2014/984067/