
Anthracyclines strike back : rediscovering non-pegylated liposomal doxorubicin in current therapeutic scenarios of breast cancer
- Author
- Francesco Schettini, Mario Giuliano, Matteo Lambertini, Rupert Bartsch, David James Pinato, Concetta Elisa Onesti, Nadia Harbeck, Diana Lueftner, Sylvie Rottey (UGent) , Peter A. van Dam, Khalil Zaman, Giorgio Mustacchi, Joseph Gligorov, Ahmad Awada, Mario Campone, Hans Wildiers, Alessandra Gennari, Vivianne C. G. Tjan-Heijnen, Javier Cortes, Mariavittoria Locci, Ida Paris, Lucia Del Mastro, Sabino De Placido, Miguel Martin, Guy Jerusalem, Sergio Venturini, Giuseppe Curigliano and Daniele Generali
- Organization
- Abstract
- Simple Summary Anthracyclines are among the most active chemotherapies in breast cancer (BC). However, they can cause structural and cumulative dose-related cardiac damage; hence, they require careful administration after preliminary functional cardiac assessment and subsequent monitoring, along with a limitation in the cumulative dose delivered. Non-pegylated liposomal doxorubicin (NPLD) has been precisely developed to optimize the doxorubicin toxicity profile, while retaining its therapeutic efficacy, thanks to a reduced diffusion in normal tissues with preserved drug penetrance into cancer sites. This has allowed administration of NPLD beyond a conventional doxorubicin maximum cumulative dose, as well as in patients with cardiac comorbilities or anthracycline pretreatment. At present, NPLD is approved in Europe and Canada in combination with cyclophosphamide as the first line of metastatic HER2-negative BC. However, given the increasing complexity of the therapeutic scenario in this setting, we have carefully revised the most updated literature on the topic and dissected the potential role of NPLD in the evolving therapeutic algorithms. Anthracyclines are among the most active chemotherapies (CT) in breast cancer (BC). However, cardiotoxicity is a risk and peculiar side effect that has been limiting their use in clinical practice, especially after the introduction of taxanes. Non-pegylated liposomal doxorubicin (NPLD) has been developed to optimize the toxicity profile induced by anthracyclines, while maintaining its unquestionable therapeutic index, thanks to its delivering characteristics that increase its diffusion in tumor tissues and reduce it in normal tissues. This feature allows NPLD to be safely administered beyond the standard doxorubicin maximum cumulative dose of 450-480 mg/m(2). Following three pivotal first-line phase III trials in HER2-negative metastatic BC (MBC), this drug was finally approved in combination with cyclophosphamide in this specific setting. Given the increasing complexity of the therapeutic scenario of HER2-negative MBC, we have carefully revised the most updated literature on the topic and dissected the potential role of NPLD in the evolving therapeutic algorithms.
- Keywords
- PHASE-III TRIAL, TRASTUZUMAB PLUS DOCETAXEL, ENCAPSULATED DOXORUBICIN, 1ST-LINE THERAPY, NAB-PACLITAXEL, CONVENTIONAL DOXORUBICIN, PRIMARY, CHEMOTHERAPY, MULTICENTER TRIAL, CYCLOPHOSPHAMIDE, EPIRUBICIN, anthracyclines, breast cancer, triple negative, hormone receptor, metastatic, non-pegylated liposomal doxorubicin
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Citation
Please use this url to cite or link to this publication: http://hdl.handle.net/1854/LU-8723322
- MLA
- Schettini, Francesco, et al. “Anthracyclines Strike Back : Rediscovering Non-Pegylated Liposomal Doxorubicin in Current Therapeutic Scenarios of Breast Cancer.” CANCERS, vol. 13, no. 17, 2021, doi:10.3390/cancers13174421.
- APA
- Schettini, F., Giuliano, M., Lambertini, M., Bartsch, R., Pinato, D. J., Onesti, C. E., … Generali, D. (2021). Anthracyclines strike back : rediscovering non-pegylated liposomal doxorubicin in current therapeutic scenarios of breast cancer. CANCERS, 13(17). https://doi.org/10.3390/cancers13174421
- Chicago author-date
- Schettini, Francesco, Mario Giuliano, Matteo Lambertini, Rupert Bartsch, David James Pinato, Concetta Elisa Onesti, Nadia Harbeck, et al. 2021. “Anthracyclines Strike Back : Rediscovering Non-Pegylated Liposomal Doxorubicin in Current Therapeutic Scenarios of Breast Cancer.” CANCERS 13 (17). https://doi.org/10.3390/cancers13174421.
- Chicago author-date (all authors)
- Schettini, Francesco, Mario Giuliano, Matteo Lambertini, Rupert Bartsch, David James Pinato, Concetta Elisa Onesti, Nadia Harbeck, Diana Lueftner, Sylvie Rottey, Peter A. van Dam, Khalil Zaman, Giorgio Mustacchi, Joseph Gligorov, Ahmad Awada, Mario Campone, Hans Wildiers, Alessandra Gennari, Vivianne C. G. Tjan-Heijnen, Javier Cortes, Mariavittoria Locci, Ida Paris, Lucia Del Mastro, Sabino De Placido, Miguel Martin, Guy Jerusalem, Sergio Venturini, Giuseppe Curigliano, and Daniele Generali. 2021. “Anthracyclines Strike Back : Rediscovering Non-Pegylated Liposomal Doxorubicin in Current Therapeutic Scenarios of Breast Cancer.” CANCERS 13 (17). doi:10.3390/cancers13174421.
- Vancouver
- 1.Schettini F, Giuliano M, Lambertini M, Bartsch R, Pinato DJ, Onesti CE, et al. Anthracyclines strike back : rediscovering non-pegylated liposomal doxorubicin in current therapeutic scenarios of breast cancer. CANCERS. 2021;13(17).
- IEEE
- [1]F. Schettini et al., “Anthracyclines strike back : rediscovering non-pegylated liposomal doxorubicin in current therapeutic scenarios of breast cancer,” CANCERS, vol. 13, no. 17, 2021.
@article{8723322, abstract = {{Simple Summary Anthracyclines are among the most active chemotherapies in breast cancer (BC). However, they can cause structural and cumulative dose-related cardiac damage; hence, they require careful administration after preliminary functional cardiac assessment and subsequent monitoring, along with a limitation in the cumulative dose delivered. Non-pegylated liposomal doxorubicin (NPLD) has been precisely developed to optimize the doxorubicin toxicity profile, while retaining its therapeutic efficacy, thanks to a reduced diffusion in normal tissues with preserved drug penetrance into cancer sites. This has allowed administration of NPLD beyond a conventional doxorubicin maximum cumulative dose, as well as in patients with cardiac comorbilities or anthracycline pretreatment. At present, NPLD is approved in Europe and Canada in combination with cyclophosphamide as the first line of metastatic HER2-negative BC. However, given the increasing complexity of the therapeutic scenario in this setting, we have carefully revised the most updated literature on the topic and dissected the potential role of NPLD in the evolving therapeutic algorithms. Anthracyclines are among the most active chemotherapies (CT) in breast cancer (BC). However, cardiotoxicity is a risk and peculiar side effect that has been limiting their use in clinical practice, especially after the introduction of taxanes. Non-pegylated liposomal doxorubicin (NPLD) has been developed to optimize the toxicity profile induced by anthracyclines, while maintaining its unquestionable therapeutic index, thanks to its delivering characteristics that increase its diffusion in tumor tissues and reduce it in normal tissues. This feature allows NPLD to be safely administered beyond the standard doxorubicin maximum cumulative dose of 450-480 mg/m(2). Following three pivotal first-line phase III trials in HER2-negative metastatic BC (MBC), this drug was finally approved in combination with cyclophosphamide in this specific setting. Given the increasing complexity of the therapeutic scenario of HER2-negative MBC, we have carefully revised the most updated literature on the topic and dissected the potential role of NPLD in the evolving therapeutic algorithms.}}, articleno = {{4421}}, author = {{Schettini, Francesco and Giuliano, Mario and Lambertini, Matteo and Bartsch, Rupert and Pinato, David James and Onesti, Concetta Elisa and Harbeck, Nadia and Lueftner, Diana and Rottey, Sylvie and van Dam, Peter A. and Zaman, Khalil and Mustacchi, Giorgio and Gligorov, Joseph and Awada, Ahmad and Campone, Mario and Wildiers, Hans and Gennari, Alessandra and Tjan-Heijnen, Vivianne C. G. and Cortes, Javier and Locci, Mariavittoria and Paris, Ida and Del Mastro, Lucia and De Placido, Sabino and Martin, Miguel and Jerusalem, Guy and Venturini, Sergio and Curigliano, Giuseppe and Generali, Daniele}}, issn = {{2072-6694}}, journal = {{CANCERS}}, keywords = {{PHASE-III TRIAL,TRASTUZUMAB PLUS DOCETAXEL,ENCAPSULATED DOXORUBICIN,1ST-LINE THERAPY,NAB-PACLITAXEL,CONVENTIONAL DOXORUBICIN,PRIMARY,CHEMOTHERAPY,MULTICENTER TRIAL,CYCLOPHOSPHAMIDE,EPIRUBICIN,anthracyclines,breast cancer,triple negative,hormone receptor,metastatic,non-pegylated liposomal doxorubicin}}, language = {{eng}}, number = {{17}}, pages = {{17}}, title = {{Anthracyclines strike back : rediscovering non-pegylated liposomal doxorubicin in current therapeutic scenarios of breast cancer}}, url = {{http://doi.org/10.3390/cancers13174421}}, volume = {{13}}, year = {{2021}}, }
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