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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| Format: | Article |
| Language: | English |
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Elsevier
2025-04-01
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| Series: | Gynecologic Oncology Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578925000529 |
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| author | Khrystyna Levytska R. Wendel Naumann Miranda J. Benfield Jubilee Brown Yovanni Casablanca Brittany Lees Allison M. Puechl Erin K. Crane |
| author_facet | Khrystyna Levytska R. Wendel Naumann Miranda J. Benfield Jubilee Brown Yovanni Casablanca Brittany Lees Allison M. Puechl Erin K. Crane |
| author_sort | Khrystyna Levytska |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-a55a19a44b0344059378452f4de6a2e0 |
| institution | OA Journals |
| issn | 2352-5789 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj-art-a55a19a44b0344059378452f4de6a2e02025-08-20T02:17:29ZengElsevierGynecologic Oncology Reports2352-57892025-04-015810172710.1016/j.gore.2025.101727Pegylated liposomal doxorubicin does not affect cardiac function in patients treated for gynecologic malignanciesKhrystyna Levytska0R. Wendel Naumann1Miranda J. Benfield2Jubilee Brown3Yovanni Casablanca4Brittany Lees5Allison M. Puechl6Erin K. Crane7Division of Gynecologic Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Corresponding author at: Cedars-Sinai Medical Center, 8635 W 3rd Street, Suite 160-W, Los Angeles, CA 90048, USA.Division of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USADivision of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USADivision of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USADivision of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USADivision of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USADivision of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USADivision of Gynecologic Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USAObjective: 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.http://www.sciencedirect.com/science/article/pii/S2352578925000529Gynecologic malignancyPegylated liposomal doxorubicinCardiotoxicityLeft ventricular ejection fractionEchocardiogram |
| spellingShingle | Khrystyna Levytska R. Wendel Naumann Miranda J. Benfield Jubilee Brown Yovanni Casablanca Brittany Lees Allison M. Puechl Erin K. Crane Pegylated liposomal doxorubicin does not affect cardiac function in patients treated for gynecologic malignancies Gynecologic Oncology Reports Gynecologic malignancy Pegylated liposomal doxorubicin Cardiotoxicity Left ventricular ejection fraction Echocardiogram |
| title | Pegylated liposomal doxorubicin does not affect cardiac function in patients treated for gynecologic malignancies |
| title_full | Pegylated liposomal doxorubicin does not affect cardiac function in patients treated for gynecologic malignancies |
| title_fullStr | Pegylated liposomal doxorubicin does not affect cardiac function in patients treated for gynecologic malignancies |
| title_full_unstemmed | Pegylated liposomal doxorubicin does not affect cardiac function in patients treated for gynecologic malignancies |
| title_short | Pegylated liposomal doxorubicin does not affect cardiac function in patients treated for gynecologic malignancies |
| title_sort | pegylated liposomal doxorubicin does not affect cardiac function in patients treated for gynecologic malignancies |
| topic | Gynecologic malignancy Pegylated liposomal doxorubicin Cardiotoxicity Left ventricular ejection fraction Echocardiogram |
| url | http://www.sciencedirect.com/science/article/pii/S2352578925000529 |
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