Tolerability, Efficacy, and Safety of Pegylated Liposomal Doxorubicin in Combination with Carboplatin Versus Gemcitabine–Carboplatin for the Treatment of Platinum-Sensitive Recurrent Ovarian Cancer: A Systematic Review

Abstract

Objective. To compare the tolerability, efficacy, and safety profiles of pegylated liposomal doxorubicin in combination with carboplatin (PLD-Carbo) with those of gemcitabine-carboplatin (Gem-Carbo) for the treatment of patients with platinum-sensitive recurrent ovarian cancer (PSROC) by reviewing the published literature.Methods. Using the PubMed database, a systematic review of peer-reviewed literature published between January 2000 and September 2009 was undertaken to identify studies related to the treatment of patients with PSROC with PLD-Carbo or Gem-Carbo. Studies reporting either response rate, progression-free survival (PFS), and/or overall survival (OS) were included. Treatment regimens, efficacy endpoints, and safety profiles were compared between the two combination therapies. The hematological safety profiles were comparable in the two groups, although grade III or IV anemia (PLDCarbo, 13.6%; Gem-Carbo, 24.5%) and neutropenia (PLD-Carbo, 45.5%; Gem-Carbo, 62.9%) were more common in patients receiving Gem-Carbo. Results. Ten studies evaluating 608 patients (PLD-Car Conclusion.Results from this systematic analysis of peer-reviewed literature suggest that PLD-Carbo therapy is a rational alternative to Gem-Carbo for the treatment of patients with PSROC. The Oncologist 2010;15: 1073-1082

A Phase Ib Open-Label, Dose-Escalation Study of NUC-1031 in Combination with Carboplatin for Recurrent Ovarian Cancer

“…Even in less heavily pretreated platinum-sensitive patients, carboplatin and gemcitabine are administered at reduced doses of AUC4 (days 1) and 1,000 mg/ m 2 (days 1 and 8), respectively, to lessen myelotoxicity (12,13). More recently, this regimen has been superseded by carboplatin and pegylated liposomal doxorubicin (PLD), wherein carboplatin can be administered at AUC5 but at a longer cycle length of 4 weeks (19). When evaluated in patients with partially platinum-sensitive ovarian cancer in the CALYPSO study, the carboplatin and PLD combination yielded an ORR of 39% (20).…”

Glioblastomas, Astrocytomas: Survival Amelioration Adding Hyperthermia to Conformal Radiotherapy and Temozolomide — Use of Pegylated Doxorubicin and Hyperthermia in the Treatment of a Recurrent Case

“…Liposomal doxorubicin (Caelyx®), is a formulation of hydrochloride doxorubicin wrapped by a film composed by phospholipids and polymers of methoxypolyethylene (mPEG) embedded in the lipid surface [33]. This association determines favorable pharmacokinetic profile characterised by an extended circulation time, a reduced volume of distribution, thereby promoting an increased tumour uptake [34,35]. Tumor abnormal microcirculation and permeability is responsible for the increased uptake and retention of liposomal drugs, see Maeda [36].…”

Major clinical research advances in gynecologic cancer in 2010

“…This suggests that PLD/carboplatin is a rational alternative to gemcitabine/carboplatin for the treatment of patients with platinum-sensitive recurrent ovarian cancer. 25 Monk et al 20 performed another influential study of the PLD in recurrent ovarian cancer, OVA-301, in which the patients were randomized to PLD alone (50 mg/m 2 ) every 4 weeks, or PLD (30 mg/m 2 ) followed by trabectedin (1.1 mg/m 2 ) every 3 weeks. The median PFS was 7.3 months with PLD/trabectedin vs. 5.8 months with PLD alone (HR, 0.79; 95% CI, 0.65 to 0.96; p= 0.0190).…”