Cancers (Sep 2021)
Anthracyclines Strike Back: Rediscovering Non-Pegylated Liposomal Doxorubicin in Current Therapeutic Scenarios of Breast Cancer
- Francesco Schettini,
- Mario Giuliano,
- Matteo Lambertini,
- Rupert Bartsch,
- David James Pinato,
- Concetta Elisa Onesti,
- Nadia Harbeck,
- Diana Lüftner,
- Sylvie Rottey,
- Peter A. van Dam,
- Khalil Zaman,
- Giorgio Mustacchi,
- Joseph Gligorov,
- Ahmad Awada,
- Mario Campone,
- Hans Wildiers,
- Alessandra Gennari,
- Vivianne C. G. Tjan-Heijnen,
- Javier Cortes,
- Mariavittoria Locci,
- Ida Paris,
- Lucia Del Mastro,
- Sabino De Placido,
- Miguel Martín,
- Guy Jerusalem,
- Sergio Venturini,
- Giuseppe Curigliano,
- Daniele Generali
Affiliations
- Francesco Schettini
- Translational Genomics and Targeted Therapies in Solid Tumors Research Group, 08036 Barcelona, Spain
- Mario Giuliano
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
- Matteo Lambertini
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, 16132 Genova, Italy
- Rupert Bartsch
- Division of Oncology, Department of Medicine 1, Medical University of Vienna, 1090 Vienna, Austria
- David James Pinato
- Division of Cancer, Department of Surgery and Cancer, Imperial College London, London SW7 2AZ, UK
- Concetta Elisa Onesti
- Clinical and Oncological Research Department, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy
- Nadia Harbeck
- Breast Center, Department OB&GYN and CCCLMU, LMU University Hospital, 81377 Munich, Germany
- Diana Lüftner
- Department of Hematology, Oncology and Tumor Immunology, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- Sylvie Rottey
- Department of Medical Oncology, UZ Gent, 9000 Gent, Belgium
- Peter A. van Dam
- Oncology Department, University Hospital Antwerp (UZA), 2650 Edegem, Belgium
- Khalil Zaman
- Oncology Department, Lausanne University Hospital CHUV, 1011 Lausanne, Switzerland
- Giorgio Mustacchi
- Division of Medical Oncology, University of Trieste, 34127 Trieste, Italy
- Joseph Gligorov
- Department of Medical Oncology, Tenon Hospital, Institut Universitaire de Cancérologie AP-HP, Sorbonne University, 75004 Paris, France
- Ahmad Awada
- Department of Medical Oncology, Institut Jules Bordet, Université Libre de Bruxelles, 1000 Bruxelles, Belgium
- Mario Campone
- Division of Medical Oncology, Institut de Cancérologie de l’Ouest-Pays de la Loire, 44800 Saint-Herblain, France
- Hans Wildiers
- Department of General Medical Oncology, University Hospital Leuven, 3000 Leuven, Belgium
- Alessandra Gennari
- Department of Translational Medicine, Università del Piemonte Orientale “A. Avogadro”, 28100 Novara, Italy
- Vivianne C. G. Tjan-Heijnen
- Division of Medical Oncology, Maastricht University Medical Center (MUMC), 6229 Maastricht, The Netherlands
- Javier Cortes
- Oncology Department, IOB Institute of Oncology, Quiron Group, 08023 Madrid, Spain
- Mariavittoria Locci
- Department of Neuroscience, Reproductive Medicine, Odontostomatology, University of Naples Federico II, 80131 Naples, Italy
- Ida Paris
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A, Gemelli IRCCS, 00168 Rome, Italy
- Lucia Del Mastro
- Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, 16132 Genova, Italy
- Sabino De Placido
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
- Miguel Martín
- Departamento de Medicina, Instituto de Investigación Sanitaria Gregorio Marañón Universidad Complutense, 28007 Madrid, Spain
- Guy Jerusalem
- Division of Medical Oncology, CHU Sart Tilman Liège and University of Liège, 4000 Liège, Belgium
- Sergio Venturini
- Management Department, University of Turin, 10124 Torino, Italy
- Giuseppe Curigliano
- Istituto Europeo di Oncologia, IRCCS ed Università di Milano, 20141 Milano, Italy
- Daniele Generali
- Department of Medicine, Surgery and Health Sciences, University of Trieste, 34127 Trieste, Italy
- DOI
- https://doi.org/10.3390/cancers13174421
- Journal volume & issue
-
Vol. 13,
no. 17
p. 4421
Abstract
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/m2. 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.
Keywords
- anthracyclines
- breast cancer
- triple negative
- hormone receptor
- metastatic
- non-pegylated liposomal doxorubicin
