Blank N, et al. – Researchers sought to illustrate the absence of cardiotoxicity with prolonged treatment and large accumulating doses of pegylated liposomal doxorubicin (PLD). This study did not notice any prevalent or incident cases of cardiotoxicity, despite prolonged treatment with large cumulative doses of PLD, adding to previous reports on shorter treatment duration.

Methods

• Patients with recurrent gynecologic cancers who underwent prolonged treatment with large cumulative doses of PLD for overt or subtle signs of cardiotoxicity (CTX) using standard and advanced echocardiography techniques [3D volumetric method for left ventricular ejection fraction (LVEF) and left ventricular/right ventricular global longitudinal strain] were screened.
• They found previous echocardiographic studies available for comparison in 50% of the patients.

Results

• Accumulating dose of 1387 ± 483 mg (range 780–2538 mg), the average PLD treatment duration was 23.6 ± 10.8 months (range 13–57).
• Results revealed normal LVEF both by 2D-echo (60 ± 5%, range 50–67) and 3D echo (58 ± 5%, range 46–63) in the study group.
• They observed minimally reduced ejection fraction in two patients (14%) by 2D and 3D echo (50%/46% and 51%/49%, respectively) that did not meet the current definition of CTX.
• The average LVEF remained stable between studies, for the seven patients who had consecutive echocardiography studies.
• There was no change in average left ventricular/right ventricular global longitudinal strain as well: -20.8 ± 4.6% at the latest study and -19.3 ± 2.6% for the previous (p < 0.51).