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Liposome-encapsulated doxorubicin citrate in previously treated recurrent/metastatic gynecological malignancies
  1. R. Angioli*,
  2. I. Palaia,
  3. M. Calcagno,
  4. N. Manci,
  5. M. A. Zullo*,
  6. F. Bellati,
  7. G. Perniola,
  8. A. De Vivo* and
  9. P. Benedetti Panici
  1. * Department of Obstetrics and Gynecology, University Campus Bio-Medico, Rome, Italy
  2. Department of Obstetrics and Gynecology, University “La Sapienza,” Rome, Italy
  1. Address correspondence and reprint requests to: Pierluigi Benedetti Panici, MD, Department of Obstetrics and Gynecology, “La Sapienza” University of Rome, Viale del Policlinico, 155, 00169 Rome, Italy. Email: pierluigi.benedettipanici{at}


The aim of this study was to evaluate the safety and efficacy of liposome-encapsulated doxorubicin citrate (LEDC) in patients affected by recurrent/metastatic gynecological malignancies scheduled for palliative chemotherapy. Inclusion criteria were proven recurrent/advanced gynecological neoplasms, measurable/assessable disease, adequate organ function, left ventricular ejection fraction >50% as determined by echocardiography, informed consent. LEDC was administered intravenously over 1 h at the dose of either 75 mg/m2 or 60 mg/m2 (every 3 weeks until disease progression or toxicity prohibiting further therapy). From May 2003 to September 2005, 36 patients were enrolled. Primary disease was ovarian, endometrial, and cervical cancers in 15 (42%), 11 (30%), and 10 (28%) patients, respectively. LEDC was employed as third- or fourth-line chemotherapy in 25 (70%) and 11 (30%) patients, respectively. The median number of courses of LEDC received was 3 (range 2–9). Six patients (17%) achieved a partial response to treatment lasting 27 weeks and 10 patients (28%) experienced stable disease lasting 18 weeks. The predominant toxicity was hematological, especially neutropenia. Among patients receiving a dose of 75 mg/m2, two (11%) suspended therapy for febrile neutropenia, and nine (50%) required a dose reduction of 25%. As a result, the next 18 patients were treated at a reduced dose (60 mg/m2) of LEDC. Severe neutropenia (G3–G4) was significantly less common in this group (61% versus 22%; P= 0.04). LEDC has shown antineoplastic activity in previously treated recurrent/metastatic gynecological cancer patients and the toxicity profile could be considered acceptable at a 60 mg/m2 dosage.

  • gynecological neoplasms
  • liposome-encapsulated doxorubicin citrate
  • palliative chemotherapy

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