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Doxorubicin-An Agent with Multiple Mechanisms of Anticancer Activity. Cells 2023; 12:cells12040659. [PMID: 36831326 PMCID: PMC9954613 DOI: 10.3390/cells12040659] [Citation(s) in RCA: 42] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023] Open
Abstract
Doxorubicin (DOX) constitutes the major constituent of anti-cancer treatment regimens currently in clinical use. However, the precise mechanisms of DOX's action are not fully understood. Emerging evidence points to the pleiotropic anticancer activity of DOX, including its contribution to DNA damage, reactive oxygen species (ROS) production, apoptosis, senescence, autophagy, ferroptosis, and pyroptosis induction, as well as its immunomodulatory role. This review aims to collect information on the anticancer mechanisms of DOX as well as its influence on anti-tumor immune response, providing a rationale behind the importance of DOX in modern cancer therapy.
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2
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Miyazaki K. Management of elderly patients with malignant lymphoma. Jpn J Clin Oncol 2022; 52:690-699. [PMID: 35435235 DOI: 10.1093/jjco/hyac056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/02/2022] [Indexed: 11/14/2022] Open
Abstract
More than half of patients with malignant lymphoma are 65 years old or older. The outcome for older patients is poorer than that for younger patients. A poor prognosis is associated with heterogeneity and consists of physical function, performance status, poor nutritional status and various comorbidities. Therefore, attention should be given to serious treatment-related toxicities. Diffuse large B-cell lymphoma is the most frequently diagnosed type of malignant lymphoma. Most patients with diffuse large B-cell lymphoma can be potentially cured with the current standard chemotherapeutic regimen of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone. However, a reduced-dose regimen of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone or alternative treatment options might be suitable for older patients who are frail or unfit and have cardiac comorbidities. A comprehensive geriatric assessment is a potential tool for determining an appropriate therapeutic approach for each older patient. Follicular lymphoma is the second most common type of non-Hodgkin lymphoma, and the disease course is usually characterized by an indolent clinical course. Advanced follicular lymphoma with a high tumor burden has historically been treated with chemoimmunotherapy, but the treatment goal for older patients is relief of symptoms. Incorporating novel targeted agents such as brentuximab vedotin into therapies for older Hodgkin lymphoma patients might be a promising alternative to the anthracycline-containing regimen.
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Affiliation(s)
- Kana Miyazaki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
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3
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Visco C, Pregnolato F, Ferrarini I, De Marco B, Bonuomo V, Sbisà E, Fraenza C, Bernardelli A, Tanasi I, Quaglia FM, Krampera M. Efficacy of R-COMP in comparison to R-CHOP in patients with DLBCL: A systematic review and single-arm metanalysis. Crit Rev Oncol Hematol 2021; 163:103377. [PMID: 34087342 DOI: 10.1016/j.critrevonc.2021.103377] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/21/2021] [Accepted: 05/29/2021] [Indexed: 11/29/2022] Open
Abstract
Doxorubicin represents the mainstay in the upfront treatment of diffuse large B-cell lymphoma (DLBCL) patients. However, its administration is sometimes hampered by the coexistence of former comorbidities/cardiac issues, especially in the elderly population. Liposome encapsulated drug delivery systems have been adopted to reduce the exposure of normal tissues to the drug, both in solid cancers and lymphomas. Despite claims for lower toxicity, the efficacy of non-pegylated liposome doxorubicin (NPLD) in DLBCL, as compared to standard doxorubicin, has never been established. We systematically reviewed relevant literature of NPLD in lymphoma treatment. Adjusting for age/comorbidities, our metanalysis revealed that the use of combinations including NPLD (R-COMP) were non-inferior in terms of response, overall and progression-free survival to the standard of care (R-CHOP) in overlapping series of DLBCL patients. R-COMP may represent a safe and active option for elderly patients with DLBCL, or for those with some extent of cardiac impairment at baseline.
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Affiliation(s)
- Carlo Visco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy.
| | - Francesca Pregnolato
- Experimental Laboratory of Immuno-rheumatology, Istituto Auxologico Italiano, IRCCS, Cusano Milanino, Milan, Italy
| | - Isacco Ferrarini
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Beatrice De Marco
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Valentina Bonuomo
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Eugenio Sbisà
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Costanza Fraenza
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Andrea Bernardelli
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | - Ilaria Tanasi
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
| | | | - Mauro Krampera
- Department of Medicine, Section of Hematology, University of Verona, Verona, Italy
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4
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Tavares A, Moreira I. Diffuse large B-cell lymphoma in very elderly patients: Towards best tailored treatment - A systematic review. Crit Rev Oncol Hematol 2021; 160:103294. [PMID: 33675907 DOI: 10.1016/j.critrevonc.2021.103294] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/02/2021] [Accepted: 02/27/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Diffuse large B cell Lymphoma (DLBCL) is a potentially curative lymphoma with increasing incidence with ageing. Treatment of elderly DLBCL patients represents a particular challenge due to their comorbidities and performance status. METHODS A search for original articles focused on the treatment of elderly DLBCL patients was performed in PubMed database and 633 were found and reviewed. Thirty-eight studies meeting our inclusion criteria were published since 2007. RESULTS Thirteen studies were retrospective and 25 phase II/III clinical trials. Most of them investigated the efficacy of dose-adjusted R-CHOP regimen. Alternative therapeutic drugs together with geriatric assessment were also evaluated. For fit patients aged 80 and over, the strongest evidence favours R-miniCHOP regimen. CONCLUSION A dose-adjusted R-CHOP may be the recommended treatment in elderly DLBCL patients. New tools such as the Comprehensive Geriatric Assessment provide useful guidance for treatment choice, based on comorbidities and frailty index of this group.
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Affiliation(s)
- Alda Tavares
- Department of Medical Oncology, Hospital Pedro Hispano, Matosinhos Local Health Unit, Matosinhos, Portugal.
| | - Ilídia Moreira
- Department of Onco-Hematology, Portuguese Institute of Oncology of Porto, Porto, Portugal
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5
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Vyas M, Simbo DA, Mursalin M, Mishra V, Bashary R, Khatik GL. Drug Delivery Approaches for Doxorubicin in the Management of Cancers. CURRENT CANCER THERAPY REVIEWS 2020. [DOI: 10.2174/1573394716666191216114950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Aim:
We aimed to review the drug delivery approaches including a novel drug delivery
system of doxorubicin as an important anticancer drug.
Background:
Doxorubicin (DOX) is widely used against breast, uterine, ovarian, lung and cervical
cancer. It is listed among the essential medicines by WHO and is thus a very important drug
that can be used to fight against cancer. Despite its effectiveness, the use of the drug is limited due
to its dose-dependent toxicity. Several studies based on the DOX have suggested the need for
novel drug delivery formulations in the treatment of malignant and cancerous diseases due to its
cytotoxic nature.
Objectives:
This review focuses on the different formulations of DOX which is a useful drug in the
management of cancers, but associated with toxicity thus these approaches found applicability in
the reduction of its toxicity.
Methods:
We searched the scientific database using cancer, DOX, and different formulations as
the keywords. Here in only peer-reviewed research articles collected which were useful to our
current work.
Results:
This study is based on an examination of the recent advancements of its novel drug delivery
formulations. DOX hydrochloride is the first liposomal anticancer drug, administered via
the intravenous route, and also clinically approved for the treatment of lymphomas, leukemias,
and solid tumors. DOX is prepared into a liposomal formulation that contains polyethylene glycol
(PEG) layer around DOX containing liposome made by pegylation process. DOX also formulated
in nano-formulations which is also discussed herein led to reduced toxicity and increased efficacy.
Conclusion:
In the review, we described the significance of DOX in the form of different delivery
approaches in the management of cancers with a reduction in the associated toxicity.
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Affiliation(s)
- Manish Vyas
- Department of Ayurveda, School of Pharmaceutical Sciences, Lovely Professional University, Jalandhar-Delhi G.T. Road, Phagwara, Punjab-144411, India
| | - Daniel A. Simbo
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Lovely Professional University, Jalandhar-Delhi G.T. Road, Phagwara, Punjab-144411, India
| | - Mohd. Mursalin
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Lovely Professional University, Jalandhar-Delhi G.T. Road, Phagwara, Punjab-144411, India
| | - Vijay Mishra
- Department of Pharmaceutics, School of Pharmaceutical Sciences, Lovely Professional University, Jalandhar-Delhi G.T. Road, Phagwara, Punjab-144411, India
| | - Roqia Bashary
- Department of Pharmaceutical Chemistry, Kabul University, Kabul, Afghanistan
| | - Gopal L. Khatik
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Lovely Professional University, Jalandhar-Delhi G.T. Road, Phagwara, Punjab-144411, India
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Salvi F, Luminari S, Tucci A, Massidda S, Liberati AM, Stelitano C, Zanni M, Re A, Centurioni R, Freilone R, Musuraca G, Nassi L, Patti C, Arcari A, Tani M, Pulsoni A, Pavone V, Volpetti S, Peli A, Evangelista A, Spina M, Ladetto M, Merli F. Bleomycin, vinblastine and dacarbazine combined with nonpegylated liposomal doxorubicin (MBVD) in elderly (≥70 years) or cardiopathic patients with Hodgkin lymphoma: a phase-II study from Fondazione Italiana Linfomi (FIL). Leuk Lymphoma 2019; 60:2890-2898. [PMID: 31282794 DOI: 10.1080/10428194.2019.1608529] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This phase-II study assessed activity and toxicity of substituting conventional doxorubicin with nonpegylated liposomal doxorubicin in the conventional ABVD regimen for the treatment of elderly or cardiopathic patients with HL. Stage I-IIA and IIB-IV patients were treated with three courses of MBVD plus radiotherapy, or six courses of MBVD, respectively, plus radiotherapy limited to bulky or residual disease areas. The primary endpoints were CR rate and the rate of cardiac events. Forty-seven patients were enrolled. Median age was 75 years, 13 had stage I-II disease. Overall, CR was achieved by 36 patients (77%, 95% CI: 62-88), 100% and 68% in stage I-II and III-IV, respectively. With a median follow-up of 40 months (IQR: 36-45). Three-year overall survival (OS) and progression-free survival (PFS) were 70% and 43%, respectively. Cardiac events grades 3-5 were reported in two patients. In conclusion, MBVD's activity and safety profile was comparable to historical ABVD data.
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Affiliation(s)
- Flavia Salvi
- Division of Hematology, SS. Antonio e Biagio Hospital, Alessandria, Italy
| | - Stefano Luminari
- Hematology Unit, Azienda Unità Sanitaria Locale IRCCS, Reggio Emilia, Italy.,Surgical, Medical and Dental Department of Morphological Sciences related to Transplant Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandra Tucci
- Division of Haematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Stefania Massidda
- Hematology and Transplant Center, Ospedale Oncologico di Riferimento Regionale Armando Businco, Azienda Ospedaliera Brotzu, Cagliari, Italy
| | - Anna Marina Liberati
- Oncohematology and autotransplantation Unit, Azienda Ospedaliera Santa Maria, Terni, Italy
| | - Caterina Stelitano
- Division of Hematology, Azienda Ospedaliera "Bianchi Melacrino Morelli", Reggio Calabria, Italy
| | - Manuela Zanni
- Division of Hematology, SS. Antonio e Biagio Hospital, Alessandria, Italy
| | - Alessandro Re
- Division of Haematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Riccardo Centurioni
- Internal medicine and hematology Unit, Azienda Sanitaria Unica Regionale Marche AV3, Civitanova Marche, Italy
| | | | - Gerardo Musuraca
- Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy
| | - Luca Nassi
- Division of Hematology Department of Translational Medicine, Università del Piemonte Orientale and AOU Maggiore della Carità, Novara, Italy
| | - Caterina Patti
- Department of Hematology I, Azienda Ospedali Riuniti Villa Sofia-Cervello, Palermo, Italy
| | - Annalisa Arcari
- Hematology Unit and Transplantion Center, "Guglielmo da Saliceto" Hospital, Piacenza, Italy
| | - Monica Tani
- Hematology, S. Maria delle Croci Hospital, Ravenna, Italy
| | - Alessandro Pulsoni
- Department of Cellular Biotechnologies and Hematology, Policlinico Umberto I "Sapienza" University of Rome, Roma, Italy
| | - Vincenzo Pavone
- Department of Hematology and Bone Marrow Transplant, Hospital Card. G. Panico, Tricase, Italy
| | - Stefano Volpetti
- Department of Haematology, DISM Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy
| | - Annalisa Peli
- Division of Haematology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Andrea Evangelista
- Clinical and Evaluative Epidemiology Unit, AOU Città della Salute e della Scienza di Torino e CPO Piemonte, Torino, Italy
| | - Michele Spina
- Division of Medical Oncology and Immunorelated Tumors, National Cancer Institute, Aviano, Italy
| | - Marco Ladetto
- Division of Hematology, SS. Antonio e Biagio Hospital, Alessandria, Italy
| | - Francesco Merli
- Hematology Unit, Azienda Unità Sanitaria Locale IRCCS, Reggio Emilia, Italy
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7
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Limongi T, Susa F, Cauda V. Nanoparticles for hematologic diseases detection and treatment. HEMATOLOGY & MEDICAL ONCOLOGY 2019; 4:1000183. [PMID: 33860108 PMCID: PMC7610588 DOI: 10.15761/hmo.1000183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Nanotechnology, as an interdisciplinary science, combines engineering, physics, material sciences, and chemistry with the biomedicine knowhow, trying the management of a wide range of diseases. Nanoparticle-based devices holding tumor imaging, targeting and therapy capabilities are formerly under study. Since conventional hematological therapies are sometimes defined by reduced selectivity, low therapeutic efficacy and many side effects, in this review we discuss the potential advantages of the NPs' use in alternative/combined strategies. In the introduction the basic notion of nanomedicine and nanoparticles' classification are described, while in the main text nanodiagnostics, nanotherapeutics and theranostics solutions coming out from the use of a wide-ranging NPs availability are listed and discussed.
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Affiliation(s)
- Tania Limongi
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Francesca Susa
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
| | - Valentina Cauda
- Department of Applied Science and Technology, Politecnico di Torino, Corso Duca degli Abruzzi 24, 10129 Turin, Italy
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8
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Cao YW, Shi Q, Zhang MC, Xu PP, Chen S, Zhao WL, Wang L. [Efficacy of RCDOP regimen in the treatment of patients with diffuse large B-cell lymphoma]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 39:485-490. [PMID: 30032566 PMCID: PMC7342927 DOI: 10.3760/cma.j.issn.0253-2727.2018.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the efficacy of RCDOP (Rituximab, cyclophosphamide, liposome doxorubicin, vincristine and prednisone) regimen in patients with de novo diffuse large B-cell lymphoma (DLBCL), especially in those patients with multiple extra-nodal involvement or Bulky diseases. Methods: A total of 87 newly diagnosed DLBCL patients who received RCDOP regimen from October 2012 to October 2017 were enrolled into this study. Survival functions were estimated using the Kaplan-Meier method and compared by the log-rank test, and χ(2) tests were used for categorical data. Results: Among the 87 DLBCL patients treated with RCDOP regimen, 81 patients achieved complete remission (CR) or partial remission (PR), with ORR as 93.1%. Patients were further classified into groups, according to the risk factors, such as IPI scores, multiple extra-nodal involvement, bulky disease, age>60, tumor Ki-67>80%, elevated serum LDH level and advanced Ann Arbor stage. The progression-free survival (PFS, P=0.084) and overall survival (OS, P=0.515) had no statistical difference among the IPI low risk (0-1 score) group, intermediate risk (2-3 scores) group and high risk (4-5 scores) group. Similarly, no statistical difference were fou nd in PFS and OS of patients with extra-nodal involvements ≥2 (P=0.303 and P=0.624), with bulky disease (P=0.518 and P=0.466), with age>60 (P=0.600 and P=0.183), with elevated serum LDH level (P=0.054 and P=0.880), with advanced Ann Arbor stage (P=0.075 and P=0.286), and with tumor Ki-67 over 80% (P=0.190 and P=0.109), when compared with those of patients without these risk factors. Conclusion: RCDOP can improve the therapeutic effect and prognosis of DLBCL patients with certain high risk factors, such as intermediate and high IPI risks, multiple extra-nodal involvements, bulky disease, age over 60, elevated LDH level, advanced Ann Arbor stage and tumor Ki-67 over 80%.
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Affiliation(s)
- Y W Cao
- State Key Laboratory of Medical Genomics; Shanghai Institute of Hematology, Shanghai Rui Jin Hospital, Shanghai 200025, China
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9
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Abstract
PURPOSE Cancer remains a significant cause of morbidity and mortality across the globe. A recent report suggests around 14.1 million new cases and 8.2 million cancer-related deaths, which are expected to reach 21.7 million and 13 million by 2030 worldwide, respectively. MATERIALS AND METHODS Because of highly complex mechanisms of cancer progression, it is important to explore and develop new innovative technologies which are more efficient compared with presently available treatment options. RESULTS Currently, chemotherapy, radiation and surgery are the most commonly used cancer treatment methods. In the last decade, nanomedicine emerged as an alternative treatment option that uses specific drug-delivery systems, improves efficacy of drugs and reduces detrimental side effects to normal tissues. CONCLUSION In this review, we have summarized cancer nanomedicines (active and passive drug delivery) available in the market. We have also discussed other nanomedicines that are at different stages of clinical trials.
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Affiliation(s)
- Nasimudeen R Jabir
- a King Fahd Medical Research Center , King Abdulaziz University , Jeddah , Saudi Arabia
| | - Khalid Anwar
- b School of Life Sciences , Jawaharlal Nehru University , New Delhi , India
| | - Chelapram K Firoz
- a King Fahd Medical Research Center , King Abdulaziz University , Jeddah , Saudi Arabia
| | - Mohammad Oves
- c Center of Excellence in Environmental Studies , King Abdulaziz University , Jeddah , Saudi Arabia
| | - Mohammad Amjad Kamal
- a King Fahd Medical Research Center , King Abdulaziz University , Jeddah , Saudi Arabia
| | - Shams Tabrez
- a King Fahd Medical Research Center , King Abdulaziz University , Jeddah , Saudi Arabia
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10
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Beygi S, Sadashiv S, Reilly JB, Khan C, Lister J. Frontline treatment of diffuse large B-cell lymphoma in elderly: a systematic review of clinical trials in post-rituximab era. Leuk Lymphoma 2018; 59:2847-2861. [PMID: 29616868 DOI: 10.1080/10428194.2018.1443332] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Treatment of diffuse large B cell lymphoma (DLBCL) remains challenging in elderly population and systematic reviews are lacking in this area. Medline and Cochrane Register of Controlled Trials in addition to conference proceedings were searched for therapeutic clinical trials on frontline treatment of DLBCL in adults ≥60 in post-rituximab era. Forty-one out of 713 reviewed papers met our inclusion criteria. Six cycles of rituximab, cyclophosphamide, vincristine, prednisone (R-CHOP) administered every 21 d remain the standard treatment for fit elderly, with no role for maintenance rituximab. For individuals ≥80, the strongest evidence favors rituximab/ofatumumab-miniCHOP. Numerous alternative approaches including the use of liposomal anthracyclines, dose and regimen adjustment to frailty/comorbidity score, brief duration regimens, and consolidative radioimmunotherapy have produced promising outcomes and could be considered for R-CHOP inappropriate elderly. Phase III randomized trials studying the efficacy of liposomal vincristine, extended-exposure rituximab, and lenalidomide plus R-CHOP are ongoing.
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Affiliation(s)
- Sara Beygi
- a Allegheny Health Network, Department of Internal Medicine , Pittsburgh , PA , USA
| | - Santhosh Sadashiv
- b Allegheny Health Network, Division of Hematology and Cellular Therapy , West Penn Hospital , Pittsburgh , PA , USA
| | - James B Reilly
- c Allegheny Health Network, Department of Internal Medicine , Office of Graduate Medical Education , Pittsburgh , PA , USA
| | - Cyrus Khan
- b Allegheny Health Network, Division of Hematology and Cellular Therapy , West Penn Hospital , Pittsburgh , PA , USA
| | - John Lister
- b Allegheny Health Network, Division of Hematology and Cellular Therapy , West Penn Hospital , Pittsburgh , PA , USA
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Luminari S, Viel E, Ferreri AJM, Zaja F, Chimienti E, Musuraca G, Tucci A, Balzarotti M, Tani M, Salvi F, Pesce EA, Ferrari A, Liberati AM, Spadea A, Marino D, Bruno-Ventre M, Volpetti S, Bottelli C, Ravaioli E, Merli F, Spina M. Nonpegylated liposomal doxorubicin combination regimen in patients with diffuse large B-cell lymphoma and cardiac comorbidity. Results of the HEART01 phase II trial conducted by the Fondazione Italiana Linfomi. Hematol Oncol 2017; 36:68-75. [DOI: 10.1002/hon.2425] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 03/24/2017] [Accepted: 04/06/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Stefano Luminari
- Hematology; Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico; Reggio Emilia Italy
- Department of Diagnostic, Clinic and Public Health Medicine; University of Modena and Reggio Emilia; Modena Italy
| | - Elda Viel
- Cardiology Unit; National Cancer Center, Istituto di Ricovero e Cura a Carattere Scientifico; Aviano Pordenone Italy
| | | | - Francesco Zaja
- Haematology Section; DISM, Azienda Sanitaria Universitaria Integrata S. M. Misericordia; Udine Italy
| | - Emanuela Chimienti
- Division of Medical Oncology A; National Cancer Center, Istituto di Ricovero e Cura a Carattere Scientifico; Aviano Pordenone Italy
| | - Gerardo Musuraca
- Department of Hematology; Istituto Scientifico Romagnolo per Studio e Cura dei Tumori; Meldola Forlì-Cesena Italy
| | | | | | - Monica Tani
- Hematology Unit; Santa Maria delle Croci Hospital; Ravenna Italy
| | - Francesca Salvi
- Department of Hematology; SS Antonio E Biagio E Cesare Arrigo Hospital; Alessandria Italy
| | | | - Angela Ferrari
- Hematology; Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico; Reggio Emilia Italy
| | | | - Antonio Spadea
- Hematology and Stem Cell Transplant Unit; Regina Elena National Cancer Institute; Rome Italy
| | - Dario Marino
- Division of Medical Oncology 1; Istituto Oncologico Veneto-IRCCS; Padova Italy
| | - Maria Bruno-Ventre
- Unit of Lymphoid Malignancies; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - Stefano Volpetti
- Haematology Section; DISM, Azienda Sanitaria Universitaria Integrata S. M. Misericordia; Udine Italy
| | | | - Elena Ravaioli
- Division of Medical Oncology A; National Cancer Center, Istituto di Ricovero e Cura a Carattere Scientifico; Aviano Pordenone Italy
| | - Francesco Merli
- Hematology; Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico; Reggio Emilia Italy
| | - Michele Spina
- Division of Medical Oncology A; National Cancer Center, Istituto di Ricovero e Cura a Carattere Scientifico; Aviano Pordenone Italy
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12
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Iannitto E, Luminari S, Tripodo C, Mancuso S, Cesaretti M, Marcheselli L, Merli F, Stelitano C, Carella AM, Fragasso A, Montechiarello E, Ricciuti G, Pulsoni A, Paulli M, Franco V, Federico M. Rituximab with cyclophosphamide, vincristine, non-pegylated liposomal doxorubicin and prednisone as first-line treatment for splenic marginal zone lymphoma: a Fondazione Italiana Linfomi phase II study. Leuk Lymphoma 2015; 56:3281-7. [DOI: 10.3109/10428194.2015.1029925] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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13
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Li H, Guo K, Wu C, Shu L, Guo S, Hou J, Zhao N, Wei L, Man X, Zhang L. Controlled and Targeted Drug Delivery by a UV-responsive Liposome for Overcoming Chemo-resistance in Non-Hodgkin Lymphoma. Chem Biol Drug Des 2015; 86:783-94. [PMID: 25739815 DOI: 10.1111/cbdd.12551] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 01/27/2015] [Accepted: 02/26/2015] [Indexed: 12/28/2022]
Affiliation(s)
- Huafei Li
- Tumor Immunology and Gene Therapy Center; Eastern Hepatobiliary Surgery Hospital affiliated to the Second Military Medical University; 225 Changhai Road Shanghai 200433 China
- International Joint Cancer Institute; the Second Military Medical University; 800 Xiangyin Road Shanghai 200433 China
| | - Kun Guo
- Department of General Surgery/Hematology; Yancheng City No. 1 People's Hospital affiliated to Nantong Medical Collage; 16th Yuehe Road Yancheng Jiangsu Province 224005 China
| | - Cong Wu
- Department of Laboratory Diagnosis; Changhai Hospital affiliated to the Second Military Medical University; 168 Changhai Road Shanghai 200433 China
| | - Ling Shu
- Department of General Surgery/Hematology; Yancheng City No. 1 People's Hospital affiliated to Nantong Medical Collage; 16th Yuehe Road Yancheng Jiangsu Province 224005 China
| | - Shiwei Guo
- Tumor Immunology and Gene Therapy Center; Eastern Hepatobiliary Surgery Hospital affiliated to the Second Military Medical University; 225 Changhai Road Shanghai 200433 China
| | - Jing Hou
- Department of Pharmacy; Changhai Hospital affiliated to the Second Military Medical University; 168 Changhai Road Shanghai 200433 China
| | - Naping Zhao
- Department of Pharmacy; Changhai Hospital affiliated to the Second Military Medical University; 168 Changhai Road Shanghai 200433 China
| | - Lixin Wei
- Tumor Immunology and Gene Therapy Center; Eastern Hepatobiliary Surgery Hospital affiliated to the Second Military Medical University; 225 Changhai Road Shanghai 200433 China
| | - Xiaobo Man
- Tumor Immunology and Gene Therapy Center; Eastern Hepatobiliary Surgery Hospital affiliated to the Second Military Medical University; 225 Changhai Road Shanghai 200433 China
| | - Li Zhang
- Department of Pharmacy; Changhai Hospital affiliated to the Second Military Medical University; 168 Changhai Road Shanghai 200433 China
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14
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Wasle I, Gamerith G, Kocher F, Mondello P, Jaeger T, Walder A, Auberger J, Melchardt T, Linkesch W, Fiegl M, Mian M. Non-pegylated liposomal doxorubicin in lymphoma: patterns of toxicity and outcome in a large observational trial. Ann Hematol 2014; 94:593-601. [PMID: 25387663 DOI: 10.1007/s00277-014-2250-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 10/27/2014] [Indexed: 12/26/2022]
Abstract
The anthracycline doxorubicin plays a major role in the treatment of lymphoproliferative disorders. However, its use is often limited due to cardiac toxicity, which seems to be much less in the liposomal non-pegylated formulation (Myocet®). The aim of this study was the evaluation of efficacy and toxicity of Myocet®-containing treatment regimens, with a focus on cardiotoxicity during treatment in lymphoma patients. A total of 326 consecutive patients, treated between March 2008 and December 2013 in 11 Austrian and 1 Italian cancer centers, were retrospectively assessed. Patients' baseline and treatment-related parameters were obtained by reviewing hospital records. Median age was 74 years (range 26-93). The most common histology was DLBCL (60 %), followed by FL (13 %) and MCL (8 %). At least one cardiovascular comorbidity was present in 72 % of patients. Most common grade 3/4 toxicities were hematologic, namely, leukopenia, neutropenia, thrombocytopenia, and febrile neutropenia in 44, 40, 17, and 16 %. Overall, 43 patients suffered a cardiac event (any grade) with most patients developing congestive heart failure. Parameters significantly associated with severe cardiac events (grades 3-5) were the presence of cardiovascular comorbidities, chronic obstructive pulmonary disease, and elevated baseline NT-proBNP. Treatment response after first line Myocet®-containing therapy was ≥58 % among all entities (range 58-86 %) and therefore comparable to those of conventional therapeutic regimens. Herein, we provide a detailed toxicity profile of Myocet®-containing chemotherapy regimens. Despite the high rate of patients with preexisting comorbidities, the number of adverse events was encouraging. However, these results need to be confirmed in a prospective randomized trial.
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Affiliation(s)
- Ines Wasle
- Department of Internal Medicine V (Haematology and Oncology), Medical University of Innsbruck, Innsbruck, Austria
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15
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Direct cytosolic siRNA delivery by reconstituted high density lipoprotein for target-specific therapy of tumor angiogenesis. Biomaterials 2014; 35:7214-27. [DOI: 10.1016/j.biomaterials.2014.05.009] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 05/02/2014] [Indexed: 12/16/2022]
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16
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Zinzani PL, Federico M, Oliva S, Pinto A, Rigacci L, Specchia G, Tucci A, Vitolo U. The more patients you treat, the more you cure: managing cardiotoxicity in the treatment of aggressive non-Hodgkin lymphoma. Leuk Lymphoma 2014; 56:12-25. [DOI: 10.3109/10428194.2014.894187] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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17
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Assaf C, Becker JC, Beyer M, Cozzio A, Dippel E, Klemke CD, Kurschat P, Weichenthal M, Stadler R. Treatment of advanced cutaneous T-cell lymphomas with non-pegylated liposomal doxorubicin - Consensus of the lymphoma group of the Working Group Dermatologic Oncology. J Dtsch Dermatol Ges 2013; 11:338-47. [DOI: 10.1111/ddg.12012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 11/06/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Chalid Assaf
- Department of Dermatlogy; Helios Clinic Krefeld; Germany
| | - Jürgen C. Becker
- Department of Dermatology and Venereology; University of Graz; Austria
| | - Marc Beyer
- Department of Dermatolgogy, Venereology and Allergology; CharitÈ - University Medicine Berlin; Germany
| | - Antonio Cozzio
- Department of Dermatology; University Clinic Zurich; Switzerland
| | - Edgar Dippel
- Department of Dermatolgoy; Municipal Clinic Ludwigshaven; Germany
| | | | - Peter Kurschat
- Department of Dermatology and Venereology; University of Cologne; Germany
| | | | - Rudolf Stadler
- Department of Dermatolgy; Johannes Wesling Clinic Minden; Germany
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18
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Mo R, Sun Q, Xue J, Li N, Li W, Zhang C, Ping Q. Multistage pH-responsive liposomes for mitochondrial-targeted anticancer drug delivery. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2012; 24:3659-3665. [PMID: 22678851 DOI: 10.1002/adma.201201498] [Citation(s) in RCA: 189] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Indexed: 06/01/2023]
Abstract
Zwitterionic oligopeptide liposomes (HHG2C(18)-L) containing a smart lipid (1,5-dioctadecyl-L-glutamyl 2-histidyl-hexahydrobenzoic acid, HHG2C(18)) are developed to overcome the barriers faced by anticancer drugs on the route from the site of injection into the body to the final antitumor target within transport steps with multiple physiological and biological barriers. HHG2C(18)-L show the multistage pH-responsive to the tumor cell (the mitochondria in this case). Their multistage pH response leads to more effective entry of the tumor cell, improved escape from the endolysosomes, and accumulation at the mitochondria (see picture).
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Affiliation(s)
- Ran Mo
- Center of Drug Discovery, State Key Laboratory of Natural Medicines, China Pharmaceutical University, 24 Tong Jia Xiang, Nanjing 210009, PR China
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19
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Barr PM, Friedberg JW. Getting to the heart of the problem in treating diffuse large B-cell lymphoma. Leuk Lymphoma 2011; 52:1166-7. [PMID: 21612382 DOI: 10.3109/10428194.2011.577260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Paul M Barr
- James P. Wilmot Cancer Center, University of Rochester, Rochester, NY, USA
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