Cardiac safety of liposomal anthracyclines

  title={Cardiac safety of liposomal anthracyclines},
  author={Gerald Batist},
  journal={Cardiovascular Toxicology},
  • G. Batist
  • Published 25 April 2007
  • Chemistry, Biology
  • Cardiovascular Toxicology
Anthracyclines remain amongst the most active therapeutic agents for breast cancer treatment. Rather than being supplanted by novel targeted agents, they are being combined with them in various schedules. Furthermore, anthracyclines themselves are still being studied, with increasing biological understanding of their biological activity and molecular targets. A cardiac safe formulation of doxorubicin opens a number of interesting therapeutic opportunities. Liposomal doxorubicins appear to… 

Anthracycline cardiotoxicity: from bench to bedside.

The First International Workshop on Anthracycline Cardiotoxicity, held in fall 2006, focused on the state-of-the-art knowledge and discussed the research needed to address the cardiotoxicity of these drugs and is incorporated into the framework of a broader review of preclinical and clinical issues.

Cardiotoxicity of antitumor drugs.

Mechanism-based considerations and retrospective analyses of clinical trials now form the basis for a new classification of cardiotoxicity, type I for anthracyclines vs type II for Trastuzumab, which may serve a template to accommodate other paradigms ofCardiotoxicity induced by new drugs and combination therapies.

Ultrasound enhanced antitumor activity of liposomal doxorubicin in mice

The tumor uptake properties and therapeutic efficacy of 1,2 distearoyl-sn-glycero-3-phosphatidylethanolamine-based liposomes containing DXR were investigated in nude mice bearing tumor xenografts and upon exposure to low frequency US in situ inhibition of tumor growth was demonstrated.

Towards the use of localised delivery strategies to counteract cancer therapy-induced cardiotoxicities.

This review summarises the advancements in localised delivery of anti-cancer therapies to tumours and examines the localised Delivery of cardioprotectants to the heart for patients with systemic disease where localised tumour delivery might not be an option.

The anthracyclines: When good things go bad

An overwhelming amount of clinical evidence suggests that anthracyclines are too good to be old, and they would look much better if they caused less harm to the heart when administered as either single agents or in combination with otherwise promising new drugs.

Clinical Developments in Nanotechnology for Cancer Therapy

ABSTRACTNanoparticle approaches to drug delivery for cancer offer exciting and potentially “game-changing” ways to improve patient care and quality of life in numerous ways, such as reducing

Targeted delivery of anti-cancer drugs by MS2 virus-like particles

This project highlights the versatility of VLPs for displaying a range of useful ligands on their surface, as well as packaging various therapeutic cargos, and demonstrated their ability to specifically deliver drugs to targeted cancer cells.

The concomitant management of cancer therapy and cardiac therapy.



Reduced cardiotoxicity and preserved antitumor efficacy of liposome-encapsulated doxorubicin and cyclophosphamide compared with conventional doxorubicin and cyclophosphamide in a randomized, multicenter trial of metastatic breast cancer.

  • G. BatistG. Ramakrishnan L. Lee
  • Medicine, Biology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2001
Myocet improves the therapeutic index of doxorubicin by significantly reducing cardiotoxicity and grade 4 neutropenia and provides comparable antitumor efficacy, when used in combination with cyclophosphamide as first-line therapy for MBC.

Improved anti-tumor response rate with decreased cardiotoxicity of non-pegylated liposomal doxorubicin compared with conventional doxorubicin in first-line treatment of metastatic breast cancer in patients who had received prior adjuvant doxorubicin: results of a retrospective analysis

Treatment based on non-pegylated liposomal doxorubicin (Myocet) significantly reduced the risk of cardiotoxicity in patients with metastatic breast cancer who had received prior adjuvant anthracycline treatment and were at high risk of developing iatrogenic cardiomyopathy.

Pegylated liposomal doxorubicin and cyclophosphamide as first-line therapy for patients with metastatic or recurrent breast cancer.

First-line combination therapy with PLD and cyclophosphamide is active and well tolerated in patients with MBC.

Pharmacokinetics of doxorubicin administered i.v. as Myocet (TLC D-99; liposome-encapsulated doxorubicin citrate) compared with conventional doxorubicin when given in combination with cyclophosphamide in patients with metastatic breast cancer

There was a correlation between the plasma AUC0−∞ of total doxorubicin and the degree of myelosuppression in patients receiving conventional doxorbicin, but this correlation was not found in patients received TLC D-99.

Pegylated liposomal doxorubicin and trastuzumab in HER-2 overexpressing metastatic breast cancer: a multicenter phase II trial.

  • S. ChiaM. Clemons L. Panasci
  • Medicine, Biology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2006
The combination of PLD and trastuzumab is a well tolerated and active regimen in HER-2-positive MBC and cardiotoxicity was observed, but limited to asymptomatic declines in LVEF.

Use of chemotherapy plus a monoclonal antibody against HER2 for metastatic breast cancer that overexpresses HER2.

The addition of trastuzumab to chemotherapy was associated with a longer time to disease progression, a higher rate of objective response, a longer duration of response, and a lower rate of death at 1 year.

HER2 and responsiveness of breast cancer to adjuvant chemotherapy.

Amplification of HER2 in breast-cancer cells is associated with clinical responsiveness to anthracycline-containing chemotherapy regimens and was associated with a poor prognosis regardless of the type of treatment.

retrospective analysis of topoisomerase IIa amplifications and deletions as predictive markers in primary breast cancer patients randomly assigned to cyclophosphamide, methotrexate, and fluorouracil or cyclophosphamide, epirubicin, and fluorouracil: Danish Breast Cancer Cooperative Group.

  • A. KnoopH. Knudsen B. Ejlertsen
  • Medicine, Biology
    Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 2005
TOP2A amplification-and possibly deletion-seems to be predictive markers for the effect of adjuvant epirubicin containing therapy in primary breast cancer, but a final conclusion has to await a confirmative study or a meta-analysis.

Liposome‐encapsulated doxorubicin compared with conventional doxorubicin in a randomized multicenter trial as first‐line therapy of metastatic breast carcinoma

The objective of this study was to compare the efficacy and toxicity of the liposome‐encapsulated doxorubicin, TLC D‐99 (Myocet, Elan Pharmaceuticals, Princeton, NJ), and conventional doxorubicin in