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Early Evidence of Cardiotoxicity and Tumor Response in Patients with Sarcomas after High Cumulative Dose Doxorubicin Given as a Continuous Infusion

BACKGROUND: Despite the dose-dependent response rate of sarcomas to doxorubicin, clinicians limit its cumulative dose due to cardiotoxicity. This study evaluates early evidence of cardiotoxicity in patients treated with high-dose doxorubicin given as a continuous infusion. METHODS: Data was collecte...

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Autores principales: Quintana, Raymundo A., Banchs, Jose, Gupta, Ridhi, Lin, Heather Y., Raj, Sean D., Conley, Anthony, Ravi, Vinod, Araujo, Dejka, Benjamin, Robert S., Patel, Shreyaskumar, Vadhan-Raj, Saroj, Somaiah, Neeta
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634608/
https://www.ncbi.nlm.nih.gov/pubmed/29081684
http://dx.doi.org/10.1155/2017/7495914
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author Quintana, Raymundo A.
Banchs, Jose
Gupta, Ridhi
Lin, Heather Y.
Raj, Sean D.
Conley, Anthony
Ravi, Vinod
Araujo, Dejka
Benjamin, Robert S.
Patel, Shreyaskumar
Vadhan-Raj, Saroj
Somaiah, Neeta
author_facet Quintana, Raymundo A.
Banchs, Jose
Gupta, Ridhi
Lin, Heather Y.
Raj, Sean D.
Conley, Anthony
Ravi, Vinod
Araujo, Dejka
Benjamin, Robert S.
Patel, Shreyaskumar
Vadhan-Raj, Saroj
Somaiah, Neeta
author_sort Quintana, Raymundo A.
collection PubMed
description BACKGROUND: Despite the dose-dependent response rate of sarcomas to doxorubicin, clinicians limit its cumulative dose due to cardiotoxicity. This study evaluates early evidence of cardiotoxicity in patients treated with high-dose doxorubicin given as a continuous infusion. METHODS: Data was collected on patients who received 90 mg/m(2) doxorubicin as a continuous infusion and 10 gm/m(2) ifosfamide for up to 6 cycles as part of a phase II study. Cardiotoxicity was assessed with serial echocardiograms or multigated acquisition scans and serum brain natriuretic peptide and troponin levels. Tumor responses were determined by serial radiographic imaging per RECIST. RESULT: Out of the 48 patients enrolled, no patient developed heart failure symptoms; however, 4 out of the 38 (10%) patients with serial left ventricular ejection fraction assessments developed subclinical cardiotoxicity (asymptomatic drop in LVEF ≥ 10%). Twenty-three patients received all six 72-hour cycles of doxorubicin with a mean cumulative dose of 540 mg/m(2). Among these patients, 4% (n = 1) developed subclinical cardiotoxicity. In the advanced disease group (n = 39), patients with a complete or partial response received a higher mean cumulative dose than those with stable disease (p < 0.033). CONCLUSIONS: Doxorubicin cardiotoxicity can be limited by administering doxorubicin as a continuous infusion, allowing higher cumulative dosing to maximize efficacy.
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spelling pubmed-56346082017-10-29 Early Evidence of Cardiotoxicity and Tumor Response in Patients with Sarcomas after High Cumulative Dose Doxorubicin Given as a Continuous Infusion Quintana, Raymundo A. Banchs, Jose Gupta, Ridhi Lin, Heather Y. Raj, Sean D. Conley, Anthony Ravi, Vinod Araujo, Dejka Benjamin, Robert S. Patel, Shreyaskumar Vadhan-Raj, Saroj Somaiah, Neeta Sarcoma Research Article BACKGROUND: Despite the dose-dependent response rate of sarcomas to doxorubicin, clinicians limit its cumulative dose due to cardiotoxicity. This study evaluates early evidence of cardiotoxicity in patients treated with high-dose doxorubicin given as a continuous infusion. METHODS: Data was collected on patients who received 90 mg/m(2) doxorubicin as a continuous infusion and 10 gm/m(2) ifosfamide for up to 6 cycles as part of a phase II study. Cardiotoxicity was assessed with serial echocardiograms or multigated acquisition scans and serum brain natriuretic peptide and troponin levels. Tumor responses were determined by serial radiographic imaging per RECIST. RESULT: Out of the 48 patients enrolled, no patient developed heart failure symptoms; however, 4 out of the 38 (10%) patients with serial left ventricular ejection fraction assessments developed subclinical cardiotoxicity (asymptomatic drop in LVEF ≥ 10%). Twenty-three patients received all six 72-hour cycles of doxorubicin with a mean cumulative dose of 540 mg/m(2). Among these patients, 4% (n = 1) developed subclinical cardiotoxicity. In the advanced disease group (n = 39), patients with a complete or partial response received a higher mean cumulative dose than those with stable disease (p < 0.033). CONCLUSIONS: Doxorubicin cardiotoxicity can be limited by administering doxorubicin as a continuous infusion, allowing higher cumulative dosing to maximize efficacy. Hindawi 2017 2017-09-26 /pmc/articles/PMC5634608/ /pubmed/29081684 http://dx.doi.org/10.1155/2017/7495914 Text en Copyright © 2017 Raymundo A. Quintana et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Quintana, Raymundo A.
Banchs, Jose
Gupta, Ridhi
Lin, Heather Y.
Raj, Sean D.
Conley, Anthony
Ravi, Vinod
Araujo, Dejka
Benjamin, Robert S.
Patel, Shreyaskumar
Vadhan-Raj, Saroj
Somaiah, Neeta
Early Evidence of Cardiotoxicity and Tumor Response in Patients with Sarcomas after High Cumulative Dose Doxorubicin Given as a Continuous Infusion
title Early Evidence of Cardiotoxicity and Tumor Response in Patients with Sarcomas after High Cumulative Dose Doxorubicin Given as a Continuous Infusion
title_full Early Evidence of Cardiotoxicity and Tumor Response in Patients with Sarcomas after High Cumulative Dose Doxorubicin Given as a Continuous Infusion
title_fullStr Early Evidence of Cardiotoxicity and Tumor Response in Patients with Sarcomas after High Cumulative Dose Doxorubicin Given as a Continuous Infusion
title_full_unstemmed Early Evidence of Cardiotoxicity and Tumor Response in Patients with Sarcomas after High Cumulative Dose Doxorubicin Given as a Continuous Infusion
title_short Early Evidence of Cardiotoxicity and Tumor Response in Patients with Sarcomas after High Cumulative Dose Doxorubicin Given as a Continuous Infusion
title_sort early evidence of cardiotoxicity and tumor response in patients with sarcomas after high cumulative dose doxorubicin given as a continuous infusion
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5634608/
https://www.ncbi.nlm.nih.gov/pubmed/29081684
http://dx.doi.org/10.1155/2017/7495914
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