Bi-weekly liposomal doxorubicin for advanced breast cancer in elderly women (≥ 70 years).

Abstract

BACKGROUND:

We conducted a multicenter prospective trial to assess tolerability and activity of pegylated liposomal doxorubicin (PLD) in women ≥ 70 years with locally-advanced or metastatic breast cancer.

PATIENTS AND METHODS:

All patients underwent Multidimensional Geriatric Assessment (MGA). Frail patients were excluded. Normal cardiac function was required for inclusion. A bi-weekly schedule of PLD at 20mg/mq was adopted.

RESULTS:

Thirty-two patients were enrolled with a median age of 78 years, 78.1% with visceral involvement, and 37.6% previously treated with chemotherapy for advanced disease. A mean of 7.8 cycles were delivered (range 1 to 20), with a median cumulative dose intensity of 8.9 mg/m(2)/week. Grade 3-4 toxicities were anemia (6.3%), palmar-plantar erythrodysesthesia (6.3%), mucositis (6.3%), infection (3.1%), and pulmonary embolism (3.1%). No cardiac events were registered. Causes of treatment interruption were maximal response (15.6%), progression (40.6%), refusal/loss to follow-up (28.1%), toxicities (9.4%), or other (6.3%). Response was obtained in 33.3% of 27 evaluable patients; median time to progression (TTP) was 10.3 months. MGA status (vulnerable vs. fit) did not have an impact on response, progression, and toxicity.

CONCLUSIONS:

Bi-weekly PLD is well tolerated in both fit and vulnerable patients, with an apparently fairly good response rate and TTP (possibly biased by subsequent endocrine therapy and loss to follow-up). Close observation of patients is recommended in order to avoid early refusal/loss to follow-up.

• Authors: Umberto Basso, Anna Roma, Antonella Brunello, Cristina Falci, Pasquale Fiduccia, Alberto Banzato, Antonio Bononi, Milena Gusella, Lampros Vamvakas, Vittorina Zagonel, Silvio Monfardini
• Journal: Journal of geriatric oncology (J Geriatr Oncol) Vol. 4 Issue 4 Pg. 340-5 (Oct 2013) ISSN: 1879-4076 [Electronic] Netherlands
• PMID: 24472477 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2013.

Chemical References

• Antibiotics, Antineoplastic
• liposomal doxorubicin
• Polyethylene Glycols
• Doxorubicin

Topics

• Aged
• Aged, 80 and over
• Antibiotics, Antineoplastic (administration & dosage, adverse effects, therapeutic use)
• Breast Neoplasms (drug therapy)
• Disease-Free Survival
• Doxorubicin (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Drug Administration Schedule
• Drug-Related Side Effects and Adverse Reactions (etiology)
• Female
• Humans
• Polyethylene Glycols (administration & dosage, adverse effects, therapeutic use)
• Prospective Studies
• Treatment Outcome