Doxorubicin coated in tiny droplets of oil is as effective as the standard formulation but much
less toxic when used to treat women with advanced breast cancer. Doxorubicin is
known to cause damage to individual muscles and the blood vessels of the heart,
thereby raising the risk of heart failure to as high as 5% in patients receiving
the maximum recommended dose. According to a recent study, surrounding
doxorubicin by protective liposomes allows it to flow through the heart without
dissolving, thus lowering the risk of heart damage.
Passes Through the Heart
In a phase III clinical trial in 297 patients, only 6% of those with
metastasized breast cancer developed cardiotoxicity when treated with a
liposome-encapsulated doxorubicin preparation known as Myocet (approved for use
in Europe but investigational in the United States and Canada),* compared to 21%
of those treated with standard doxorubicin. Both groups of patients also
received cyclophosphamide (Cytoxan, Neosar), and both had equivalent response
"Liposome-encapsulated doxorubicin passes right through the heart and
lodges in organs such as the liver and in the blood vessels that feed tumors,
and then slowly dissolves, allowing the doxorubicin to fight the cancer
cells," said the study’s lead author Gerald Batist, MD, a professor at
McGill University and director of the Center for Translational Research in
Cancer at Jewish General Hospital, Montreal, Quebec.
This means physicians may be able to treat patients with the liposomal
formulation of doxorubicin for longer periods than is now possible with the
standard formulation. "Although doxorubicin is the single most active
treatment for breast cancer, it comes with a risk of cardiotoxicity, and the
more it is used, the greater the risk," said Dr. Batist. "By using
liposome-encapsulated doxorubicin, patients may be able to stay on treatment
longer or receive additional treatment if their cancer recurs, while reducing
their risk of cardiotoxicity."
* Liposomal doxorubicin is available as Doxil in the United States.