Anthracyclines Strike Back: Rediscovering Non-Pegylated Liposomal Doxorubicin in Current Therapeutic Scenarios of Breast Cancer

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 deve...

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Published inCancers Vol. 13; no. 17; p. 4421
Main Authors Schettini, Francesco, Giuliano, Mario, Lambertini, Matteo, Bartsch, Rupert, Pinato, David James, Onesti, Concetta Elisa, Harbeck, Nadia, Lüftner, Diana, Rottey, Sylvie, van Dam, Peter A, Zaman, Khalil, Mustacchi, Giorgio, Gligorov, Joseph, Awada, Ahmad, Campone, Mario, Wildiers, Hans, Gennari, Alessandra, Tjan-Heijnen, Vivianne C G, Cortes, Javier, Locci, Mariavittoria, Paris, Ida, Del Mastro, Lucia, De Placido, Sabino, Martín, Miguel, Jerusalem, Guy, Venturini, Sergio, Curigliano, Giuseppe, Generali, Daniele
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 01.09.2021
MDPI
Subjects
Algorithms
Alopecia
Anemia
Anthracycline
Baldness
Breast cancer
Cardiotoxicity
Chemotherapy
Clinical medicine
Clinical trials
Cyclophosphamide
Doxorubicin
Drug dosages
Ejection fraction
ErbB-2 protein
Heart
Heart failure
Leukopenia
Metastases
Metastasis
Mucositis
Neutropenia
Pharmacodynamics
Pharmacokinetics
Response rates
Review
Toxicity
triple negative
breast cancer
anthracyclines
metastatic
hormone receptor
non-pegylated liposomal doxorubicin
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Summary: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 . 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.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers13174421