期刊
JOURNAL OF GERIATRIC ONCOLOGY
卷 4, 期 4, 页码 340-345出版社
ELSEVIER
DOI: 10.1016/j.jgo.2013.07.004
关键词
Anthracyclines; Breast cancer; Chemotherapy; Elderly; Liposomal doxorubicin; Toxicity
Background: We conducted a multicenter prospective trial to assess tolerability and activity of pegylated liposomal doxorubicin (PLD) in women >= 70 years with locally-advanced or metastatic breast cancer. Patients and Methods: All patients underwent Multidimensional Geriatric Assessment (MGA). Frail patients were excluded. Normal cardiac function was required for inclusion. A bi-weekly schedule of PLD at 20 mg/mq was adopted. Results: Thirty-two patients were enrolled with a median age of 78 years, 78.1% with visceral involvement, and 37.6% previously treated with chemotherapy for advanced disease. A mean of 7.8 cycles were delivered (range 1 to 20), with a median cumulative dose intensity of 8.9 mg/m(2)/week. Grade 3-4 toxicities were anemia (6.3%), palmar-plantar erythrodysesthesia (6.3%), mucositis (6.3%), infection (3.1%), and pulmonary embolism (3.1%). No cardiac events were registered. Causes of treatment interruption were maximal response (15.6%), progression (40.6%), refusal/loss to follow-up (28.1%), toxicities (9.4%), or other (6.3%). Response was obtained in 33.3% of 27 evaluable patients; median time to progression (UP) was 10.3 months. MGA status (vulnerable vs. fit) did not have an impact on response, progression, and toxicity. Conclusions: Bi-weekly PLD is well tolerated in both fit and vulnerable patients, with an apparently fairly good response rate and UP (possibly biased by subsequent endocrine therapy and loss to follow-up). Close observation of patients is recommended in order to avoid early refusal/loss to follow-up. (C) 2013 Elsevier Ltd. All rights reserved.
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