The use of liposomal doxorubicin as the next line treatment in metastatic breast cancer

Abstract

Breast cancer remains the most common malignant neoplasm in females in Poland and ranks first as the cause of death due to cancers. According to the data of Krajowy Rejestr Nowotworów (National Cancer Registry), there were 14 482 new breast cancer cases and 5255 deaths due to the disease reported in 2007. Advanced breast cancer is an incurable disease. The median survival reaches 18–24 months. However, there are cases of survival extending over several years in patients with metastatic breast cancer in a good general condition, for whom each subsequent line of treatment is a chance for slowing down the disease development and thus prolonging the survival.
Breast cancer is a chemosensitive neoplasm and some of the most active drugs employed in its treatment are anthracyclines. Application of therapeutic regimens including anthracyclines allows to achieve remission in 60–85% of patients, with a median response duration of 12 months. The adverse effect limiting the drug dosage is its cardiotoxicity, and this complication is dependent on the total drug dose — it increases significantly once 550 mg/m2 is exceeded, or 450 mg/m2 in patients receiving chest wall irradiation Currently, anthracyclines are most commonly used in perioperative treatment (as a neoadjuvant and adjuvant therapy), which limits their application in the treatment of metastatic disease. However, there are now available new drugs, including taxanes and trastuzumab, which significantly improves the therapeutic results in advanced breast cancer. Notably, some of these drugs, e.g. trastuzumab, exhibit cardiotoxic properties which increase the risk of cardiotoxicity in combined treatment.
Onkol. Prak. Klin. 2010; supl. A: A33–A36