One of the greatest failures of modern cancer therapies is the rather substantial off-target toxic effects many radio-, chemo-, and immunotherapies have. We have made great strides to improve these treatments but never-the-less struggle to get toxicity-free therapy to patients.
Cancer therapies range in methodology, mechanism of action, and effectiveness. Some therapies favor certain types of cancers, while others seem to affect a variety of cancers. Unfortunately, nearly all of these therapies essentially involve poisons that are designed to target cancer cells. As cancer cells are nearly identical to healthy cells in most ways, this often leads to off-target toxicities. These toxicities need to be accounted for before a patient engages in any specific treatment.
Breast cancer is one of the most common cancers in the world, with many well-studied treatments. One such treatment is doxorubicin, which unfortunately has some issues with cardiotoxicity. However, a newer version of doxorubicin using liposomal delivery (a type of delivery system using lipids) has shown to be less cardiotoxic than doxorubicin alone.
In a new study, a team from the Centre of Postgraduate Medical Education in Poland investigated how liposomal doxorubicin affected patient factors like overall survival and the amount of cardiotoxicity experienced. They did this by taking data from eight oncology centers in Poland and analyzing liposomal doxorubicin therapy results against other cancer therapies.
The team gathered data from 402 metastatic breast cancer patients, of which only 126 managed to complete their liposomal doxorubicin treatments. Analyzing these patients’ heart health and comparing them to patients treated with doxorubicin alone or other similar chemotherapies showed that liposomal doxorubicin was linked to a healthier heart after treatment. Overall survival comparison showed that only when liposomal doxorubicin was a secondary therapy or other specific incidences was there a significant difference.
With toxicity being a consistent issue with many cancer therapies, there is a keen interest in producing a therapy with little to no toxic side-effects. Liposomal doxorubicin is one such option, and this study found that it had lower cardiotoxicity than doxorubicin alone. This finding supports the use of liposomal doxorubicin in patients at a high risk of cardiovascular disease.
The team concludes that there needs to be more study, as several other factors increase cardiovascular disease incidence, such as diabetes. The study concludes, “in patients with metastatic BC, prolonged liposomal doxorubicin treatment, i.e. lasting more than 3.5 months, and thus the administration of a higher cumulative dose, i.e. above 300 mg/m2, significantly increases OS.”