Long-term cure of soft tissue sarcoma with pegylated-liposomal doxorubicin after doxorubicin and ifosfamide failure.

Clinical Sarcoma Research Pub Date : 2019-01-15 eCollection Date: 2019-01-01 DOI:10.1186/s13569-018-0111-0
Malvi Savani, Paari Murugan, Keith M Skubitz
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引用次数: 12

Abstract

Background: Doxorubicin is one of the most active drugs available for the treatment of sarcoma. Pegylated-liposomal doxorubicin (PLD) is a formulation of doxorubicin in which the doxorubicin is encapsulated in liposomes coated with methoxypoly (ethylene glycol); this formulation results in decreased uptake by the reticuloendothelial system, higher concentrations of drug in tumor, and less toxicity, including reduced cardiotoxicity, nausea, alopecia, and myelosuppression. No premedication is necessary. While PLD has a better toxicity profile than free doxorubicin, there is no consensus on the relative efficacy of PLD and free doxorubicin in sarcoma.

Case presentation: In this report, we describe a patient with high-grade metastatic soft tissue sarcoma with rapid recurrence after adjuvant treatment with free doxorubicin, cisplatin, ifosfamide, and dacarbazine. Second-line treatment with PLD resulted in long-term disease remission during a 20-year follow-up period. Mucositis and hand-foot syndrome were controlled by adjustment of dose and treatment interval.

Conclusions: This case illustrates the curative potential of PLD after failure of free doxorubicin and the absence of long term cardiotoxicity with PLD. As with all drugs, individual adjustment of dose and treatment interval is important.

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多柔比星聚乙二醇脂质体长期治疗多柔比星和异环磷酰胺失效后的软组织肉瘤。
背景:阿霉素是目前治疗肉瘤最有效的药物之一。聚乙二醇脂质体阿霉素(PLD)是阿霉素的一种制剂,其中阿霉素被包裹在涂有甲氧基聚乙二醇的脂质体中;这种配方导致网状内皮系统的摄取减少,肿瘤中的药物浓度更高,毒性更小,包括减少心脏毒性,恶心,脱发和骨髓抑制。不需要预先用药。虽然PLD具有比游离阿霉素更好的毒性,但对于PLD和游离阿霉素在肉瘤中的相对疗效尚无共识。病例介绍:在这个报告中,我们描述了一个高度转移性软组织肉瘤患者,在接受游离阿霉素、顺铂、异环磷酰胺和达卡巴嗪辅助治疗后迅速复发。在20年的随访期间,PLD的二线治疗导致长期疾病缓解。通过调整剂量和治疗间隔控制粘膜炎和手足综合征。结论:本病例说明游离阿霉素治疗失败后PLD的治疗潜力,并且PLD没有长期的心脏毒性。与所有药物一样,个体调整剂量和治疗间隔是重要的。
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期刊介绍: Clinical Sarcoma Research considers for publication articles related to research on sarcomas, including both soft tissue and bone. The journal publishes original articles and review articles on the diagnosis and treatment of sarcomas along with new insights in sarcoma research, which may be of immediate or future interest for diagnosis and treatment. The journal also considers negative results, especially those from studies on new agents, as it is vital for the medical community to learn whether new agents have been proven effective or ineffective within subtypes of sarcomas. The journal also aims to offer a forum for active discussion on topics of major interest for the sarcoma community, which may be related to both research results and methodological topics.
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