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Annals of Oncology Advance Access published online on February 13, 2007
Annals of Oncology, doi:10.1093/annonc/mdl484
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© 2007 European Society for Medical Oncology

Pegylated liposomal doxorubicin HCL (PLD; Caelyx/Doxil®): Experience with long-term maintenance in responding patients with recurrent epithelial ovarian cancer

E Andreopoulou1,*, D Gaiotti1, E Kim2, A Downey1, D Mirchandani1, A Hamilton3,4, Allan Jacobs4, John Curtin4 and F Muggia1

1 Division of Medical Oncology, Department of Medicine, New York University School of Medicine, New York, NY 10016
2 Long Island Jewish Medical Center, New Hyde Park, NY 11040
3 Sydney Cancer Center, Royal Prince Alfred Hospital, Australia
4 Department of Gynecologic Oncology, New York University School of Medicine, New York, NY 10016

* Correspondence to: Dr E. Andreopoulou, Department of Medical Oncology, New York University Cancer Institute, New York, NY, USA. Tel: +1-212-263-6485; Fax: +1-212-263-8210; E-mail: andree02{at}med.nyu.edu

Background: We hypothesized that a response to pegylated liposomal doxorubicin (PLD, Caelyx/Doxil) followed by maintenance is beneficial and safe in recurrent ovarian cancer.

Patients and methods: Sixteen patients have received PLD for more than 1 year for recurrent ovarian (14) or fallopian tube (2) cancer. All had stable disease or better responses to PLD + carboplatin (5) or topotecan (9) doublets or to PLD alone (2). PLD maintenance therapy 30–40 mg/m2 was given every 4–8 weeks. This analysis focuses on cardiac status, overall tolerance, and time to recurrence.

Results: Termination of PLD was due to progression in all patients. Noteworthy was the lack of cumulative myelosuppression and, with one exception, clinical cardiac toxicity. This patient was hospitalized with cardiogenic shock and fever complicating grade 4 pancytopenia from topotecan ten months after discontinuation of PLD. Seven patients continue to receive PLD after a median of 1680 mg/m2 (1180–2460 mg/m2). Four of these had documented relapses after 3–6 years on maintenance occurring in the setting of lengthening of the treatment interval. Maintenance PLD was reinstituted after ‘reinduction’ with a platinum.

Conclusions: PLD appears to be safe as long-term maintenance in ovarian cancer and may be important for a continued response.

ovarian cancer, maintenance therapy, liposomal doxorubicin

Received for publication August 25, 2006. Revision received December 4, 2006. Accepted for publication December 6, 2006.


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