Pegylated liposomal doxorubicin does not affect cardiac function in patients treated for gynecologic malignancies
Objective: Although pegylated liposomal doxorubicin (PLD) has a more favorable side-effect profile compared to doxorubicin, the FDA label for PLD includes a warning listing cardiotoxicity. Our objective was to evaluate predictors of pre- and post-treatment cardiac testing and quantify the effect of...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-04-01
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| Series: | Gynecologic Oncology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578925000529 |
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| Summary: | Objective: Although pegylated liposomal doxorubicin (PLD) has a more favorable side-effect profile compared to doxorubicin, the FDA label for PLD includes a warning listing cardiotoxicity. Our objective was to evaluate predictors of pre- and post-treatment cardiac testing and quantify the effect of PLD on cardiac function in patients treated for gynecologic malignancies. Methods: Retrospective chart review of gynecologic oncology patients who received PLD over a 10-year period at a single institution. Cardiac studies were aligned to PLD treatment and ejection fractions (EF) were compared pre- and post-treatment. Results: A total of 453 patients who had received PLD were identified; 216 (48 %) had pre-PLD treatment cardiac function testing. Predictors of pre-chemotherapy testing were diabetes (p = 0.015), higher ECOG score (p = 0.004), and cardiac disease (p = 0.032). Eighty-three (18.3 %) patients had pre- and post-PLD treatment cardiac function testing. Predictors of pre- and post- testing were number of cycles of PLD (p < 0.0001) and total dose of PLD (p < 0.0001). Seventy-five (90 %) patients had no change in EF (defined as < 10 %), while 2 (2.4 %) had improvement in EF > 10 %, and 6 (7.2 %) had a decrease in EF > 10 %. Initial EF in patients with > 10 % decrease was higher than in those without change or improvement (p = 0.0004). One (1.2 %) patient had a clinically significant decrease in EF (32.5 %) resulting in interruption of treatment. Conclusion: Risk of cardiac toxicity from administration of PLD for patients undergoing treatment for gynecologic cancers appears to be low. Selective screening of cardiac function should be employed for these patients. |
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| ISSN: | 2352-5789 |