The
Calypso trial showed an improved progression-free survival with PEG-
liposomal doxorubicin (
PLD) and
carboplatin (P) as compared with the standard regimen
paclitaxel (PCLTX) and P in the second- or third-line treatment of
platinum-sensitive
epithelial ovarian cancer [1]. A panel of Austrian gynecologic oncologists discussed the clinical consequences of the data from the
Calypso study for the routine practice.
PLD + P had a significantly lower rate of
alopecia and neuropathy than the
taxane regimen, both toxicities which compromise the quality of life. Due to possible significant
thrombocytopenia, the blood counts of patients undergoing
PLD + P
therapy should be monitored weekly. Patients receiving
PLD/P are at higher risk of
nausea and
vomiting. Palmoplantar erythrodysesthesia (
hand-foot syndrome) is a significant toxicity of
PLD + P most prevalent after the third or fourth cycle. Prophylaxis consists of avoiding pressure on feet and hands and other parts of the body. Similarly, prophylaxis of
mucositis seems important and includes avoiding consumption of hot, spicy and salty foods and drinks.
Mouth dryness should be avoided.
Premedication with
antiemetics and
dexamethasone dissolved in 5%
glucose is done to prevent
hypersensitivity to
PLD. In conclusion, the therapeutic index is more favorable for
PLD + P than for PCTX + P.