Treatment of Recurrent Platinum-Resistant Ovarian Cancer with Pegylated Liposomal Doxorubicin – An Evaluation of the Therapeutic Index with Special Emphasis on Cardiac Toxicity

Vol. 55, No. 6, 2009

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Clinical Study

Treatment of Recurrent Platinum-Resistant Ovarian Cancer with Pegylated Liposomal Doxorubicin - An Evaluation of the Therapeutic Index with Special Emphasis on Cardiac Toxicity
Ilona Steppan^a, Daniel Reimer^a, Ursula Sevelda^c, Hanno Ulmer^b, Christian Marth^a, Alain G. Zeimet^a

^aDepartment of Obstetrics and Gynecology and
^bDepartment of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, and
^cDepartment of Obstetrics and Gynecology, Wilhelminenspital, Vienna, Austria

Address of Corresponding Author

Chemotherapy 2009;55:391-398 (DOI: 10.1159/000262452)

Key Words

Cardiac toxicity
Ovarian cancer
Palmoplantar erythrodysesthesia
Pegylated liposomal doxorubicin
Platinum resistance
Quality of life
Stomatitis

Abstract

Background: To study the efficacy of pegylated liposomal doxorubicin (PLD) at a modified dose of 45 mg/m² every 4 weeks in platinum-resistant ovarian cancer and to evaluate toxicities and effects on quality of life (QoL) of this single-agent regimen. Methods: Treatment response was evaluated by CT scan or CA 125 levels. Toxicity and QoL was recorded according to the common toxicity criteria of the National Cancer Institute and the EORTC QLQ-C30 questionnaire, respectively. Results: Eighty-five patients entered this nationwide observational study (384 cycles administered) and 4 (4.7%) achieved complete and 22 (25.8%) partial remission, giving an objective response rate of 30.5%. Eight patients experienced therapy-limiting side effects prompting discontinuation of treatment. Palmoplantar erythrodysesthesia (PPE) and/or stomatitis were the main reasons for discontinuation. Grade 3-4 PPE and stomatitis occurred in 4.2 and 2.2% of the 384 cycles, respectively. Grade 3-4 cardiotoxicity was absent and overall QoL was not significantly decreased following PLD treatment. Conclusion: Single-agent PLD at a dose of 45 mg/m² is an efficient treatment in recurrent platinum-resistant ovarian cancer and exhibits an exceptionally favorable therapeutic index.

Author Contacts

Alain G. Zeimet, MD
Innsbruck Medical University, Department of Gynecology and Obstetrics
Anichstrasse 35
AT-6020 Innsbruck (Austria)
Tel. +43 512 504 81056, Fax +43 512 504 23055, E-Mail alain.zeimet@i-med.ac.at

Article Information

Received: February 23, 2009
Accepted after revision: May 21, 2009
Published online: November 30, 2009
Number of Print Pages : 8
Number of Figures : 0, Number of Tables : 5, Number of References : 36

Medline Abstract (ID 19955744)

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