Long-term cure of soft tissue sarcoma with pegylated-liposomal doxorubicin after doxorubicin and ifosfamide failure.

Doxorubicin Pegylated-liposomal doxorubicin Sarcoma

Journal

Clinical sarcoma research
ISSN: 2045-3329
Titre abrégé: Clin Sarcoma Res
Pays: England
ID NLM: 101577890

Informations de publication

Date de publication:
2019
Historique:
received: 24 09 2018
accepted: 04 12 2018
entrez: 18 1 2019
pubmed: 18 1 2019
medline: 18 1 2019
Statut: epublish

Résumé

Doxorubicin is one of the most active drugs available for the treatment of sarcoma. Pegylated-liposomal doxorubicin (PLD) is a formulation of doxorubicin in which the doxorubicin is encapsulated in liposomes coated with methoxypoly (ethylene glycol); this formulation results in decreased uptake by the reticuloendothelial system, higher concentrations of drug in tumor, and less toxicity, including reduced cardiotoxicity, nausea, alopecia, and myelosuppression. No premedication is necessary. While PLD has a better toxicity profile than free doxorubicin, there is no consensus on the relative efficacy of PLD and free doxorubicin in sarcoma. In this report, we describe a patient with high-grade metastatic soft tissue sarcoma with rapid recurrence after adjuvant treatment with free doxorubicin, cisplatin, ifosfamide, and dacarbazine. Second-line treatment with PLD resulted in long-term disease remission during a 20-year follow-up period. Mucositis and hand-foot syndrome were controlled by adjustment of dose and treatment interval. This case illustrates the curative potential of PLD after failure of free doxorubicin and the absence of long term cardiotoxicity with PLD. As with all drugs, individual adjustment of dose and treatment interval is important.

Sections du résumé

BACKGROUND BACKGROUND
Doxorubicin is one of the most active drugs available for the treatment of sarcoma. Pegylated-liposomal doxorubicin (PLD) is a formulation of doxorubicin in which the doxorubicin is encapsulated in liposomes coated with methoxypoly (ethylene glycol); this formulation results in decreased uptake by the reticuloendothelial system, higher concentrations of drug in tumor, and less toxicity, including reduced cardiotoxicity, nausea, alopecia, and myelosuppression. No premedication is necessary. While PLD has a better toxicity profile than free doxorubicin, there is no consensus on the relative efficacy of PLD and free doxorubicin in sarcoma.
CASE PRESENTATION METHODS
In this report, we describe a patient with high-grade metastatic soft tissue sarcoma with rapid recurrence after adjuvant treatment with free doxorubicin, cisplatin, ifosfamide, and dacarbazine. Second-line treatment with PLD resulted in long-term disease remission during a 20-year follow-up period. Mucositis and hand-foot syndrome were controlled by adjustment of dose and treatment interval.
CONCLUSIONS CONCLUSIONS
This case illustrates the curative potential of PLD after failure of free doxorubicin and the absence of long term cardiotoxicity with PLD. As with all drugs, individual adjustment of dose and treatment interval is important.

Identifiants

pubmed: 30651969
doi: 10.1186/s13569-018-0111-0
pii: 111
pmc: PMC6332634
doi:

Types de publication

Case Reports

Langues

eng

Pagination

1

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Auteurs

Malvi Savani (M)

1Department of Medicine, University of Minnesota Medical School, Office Mayo Mail Code 480, 420 Delaware St. SE, Minneapolis, MN 55455 USA.

Paari Murugan (P)

2Masonic Cancer Center, Minneapolis, MN USA.
3Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN USA.

Keith M Skubitz (KM)

1Department of Medicine, University of Minnesota Medical School, Office Mayo Mail Code 480, 420 Delaware St. SE, Minneapolis, MN 55455 USA.
2Masonic Cancer Center, Minneapolis, MN USA.

Classifications MeSH