The Biodistribution and Pharmacokinetics of Stealth Liposomes in Patients with Solid Tumors
October 1st 1997Liposomes have been proposed as potential vehicles for drug therapy targeted to solid tumors, in particular, because of the increased permeability of these tumors to macromolecules. The recent development of Stealth
Future Prospects for Stealth Liposomes in Cancer Therapy
October 1st 1997While doxorubicin (Adriamycin) is among the most active single agents in the treatment of breast cancer and other solid tumors, its concomitant toxicity limits its use. Quality-of-life issues have driven the search for gentler,
A Safety Review of Pegylated Liposomal Doxorubicin in the Treatment of Various Malignancies
October 1st 1997Many of the more commonly observed adverse effects of standard doxorubicin (Adriamycin) are lessened by pegylated liposomal delivery (Doxil). The slow release of doxorubicin into normal tissue cells via this form of liposomal delivery ameliorates its potential for severe alopecia, nausea and vomiting, cardiotoxicity, and myelosuppressive toxicity. Infusion-related acute reactions are managed by slowing infusion rates and thorough dilution and mixing of the infused drug. Vesicant properties normally seen with doxorubicin are absent. Palmar-plantar erythrodysesthesia can be reduced by decreasing the dose or increasing the dosing interval. Many of these side effects are developing a predictable profile and are manageable. Because of its overall reduced toxicity profile, pegylated liposomal doxorubicin may be well-suited for use in combination chemotherapeutic regimens. [ONCOLOGY 11(Suppl 11):54-62, 1997]
Liposomal Anthracycline Chemotherapy in the Treatment of AIDS-Related Kaposi’s Sarcoma
October 1st 1997The treatments employed for Kaposi’s sarcoma in patients with acquired immunodeficiency syndrome (AIDS-KS) have been limited in their usefulness by toxicities and underlying immunodeficiency in this patient population.
Pegylated Liposomal Doxorubicin: Scientific Rationale and Preclinical Pharmacology
October 1st 1997Liposome-encapsulated drug delivery is a methodology that has been evolving over the past 30 years. A number of liposome-encapsulated anthracycline products are in development and two, pegylated liposomal doxorubicin
After pegylated liposomal doxorubicin (PEG-LD) (Doxil) was shown to be active in ovarian tumors, several trials were developed at the University of Southern California to determine its safety and efficacy in a variety of gynecologic and peritoneal malignancies. Completed phase I and phase II trials have found PEG-LD to be safe and effective in the treatment of platinum- and paclitaxel-refractory epithelial ovarian carcinoma. A new phase II trial is currently underway in similarly refractory patients with ovarian and other related cancers and various degrees of pretreatment. In addition, the efficacy of PEG-LD is being explored in combination with paclitaxel (Taxol), with cisplatin, and with hyperthermia. [ONCOLOGY 11(Suppl 11):38-44, 1997]
Is Axillary Dissection Always Indicated in Invasive Breast Cancer?
October 1st 1997In light of the changing trends in the diagnosis and management of invasive breast cancer, the practice of routine axillary dissection should be reevaluated. A growing number of patients with breast cancer are diagnosed as
Management of Progressive Metastatic Prostate Cancer
October 1st 1997This review succinctly summarizes a relatively large body of literature surrounding the treatment of advanced, stage D2 (M+) prostate cancer. However, the patient with classic stage D2 prostate cancer, presenting de novo with multiple sites of bony metastasis, pain, and other systemic symptoms, is becoming less common in clinical practice. In 1997, prostate cancer is most commonly diagnosed in a locally advanced form, either clinically or pathologically stage C (T3), and accounts for approximately 60% of all newly diagnosed cases in the United States.[1] The reasons for this “stage migration” undoubtedly lie in the widespread use of prostate-specific antigen (PSA) for the detection of prostate cancer while still organ-confined, and in the use of PSA to monitor patients who have undergone definitive local treatment.
The Timing of Breast Cancer Surgery During the Menstrual Cycle
October 1st 1997Contemporary breast cancer treatment research has focused on systemic postoperative adjuvant treatment and the elimination of established micrometastases. An alternative approach addresses the potential for seeding at the time of primary surgery. Several retrospective reports have suggested that the hormonal milieu during lumpectomy or mastectomy impacts on the likelihood of tumor cell shedding and implantation at distant sites.
Is Axillary Dissection Always Indicated in Invasive Breast Cancer?
October 1st 1997The article written by Chadha and Axelrod provides a timely discussion of several critical issues in the current debate over the use of axillary lymph node dissection in early-stage breast cancer. As new information and techniques become available, they and others have reassessed the value of axillary lymph node dissection in four key areas:
Rationale for Trials Studying Pegylated Liposomal Doxorubicin in Metastatic Breast Cancer
Breast cancer is second only to lung cancer as a leading cause of cancer mortality in women. In women with metastatic, hence, essentially incurable disease, we strive to find effective chemotherapeutic regimens that offer a