Non-Pegylated Liposomal Doxorubicin-Cyclophosphamide in Sequential Regimens with Taxanes as Neoadjuvant Chemotherapy in Breast Cancer Patients

The results of our study suggest that non-pegylated liposomal doxorubicin may offer an attractive alternative to conventional anthracyclines in the treatment of early breast cancer

Patrizia Vici


Scholarcy highlights

  • Neoadjuvant chemotherapy is commonly employed in operable and locally advanced breast carcinoma
  • A recent meta-analysis, including nine randomized trials comparing in various tumors including advanced breast cancer, and liposomal and conventional anthracyclines, confirms that liposomal formulation offers an alternative to conventional anthracyclines for patients with previous history of cardiac disease, elderly or “frail”
  • A pathological complete response at surgery was observed in 10 patients; in 35 patients a partial response was observed, whereas no patients progressed onto therapy
  • Their limits reside in the low therapeutic index, mainly for cumulative cardiotoxicity, where current standard chemotherapy regimens may not be adequate for all breast cancer patients, such as elderly patients or patients with comorbidities
  • Neoadjuvant chemotherapy has been widely used in patients with operable and locally advanced breast cancer in order to increase the rate of breast conserving surgery and to obtain a better long-term outcome, and sequential regimens of anthracycline-based schemes followed or preceded by a taxane are considered the “standard” even outside clinical trials
  • No significant differences in toxicity were observed according to age or any other prognostic factor
  • Even if further data are required to confirm these promising findings, in the longer term, our analysis indicate an efficacy comparable to the literature data, and confirmed a favourable toxicity profile, suggesting that non-pegylated liposomal doxorubicin-based regimens as primary chemotherapy may improve therapeutic index in patients not suitable to receiving a conventional anthracycline-based neoadjuvant chemotherapy, and outside of clinical trials in everyday clinical practice
  • non-pegylated liposomal doxorubicin-cyclophosphamide and taxanes sequential regimens were proven effective and well tolerated in breast cancer patients with contra-indication to conventional anthracyclines undergoing neoadjuvant chemotherapy, even outside of clinical trials in everyday clinical practice

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