Long-term pegylated liposomal doxorubicin use in recurrent ovarian carcinoma

Ovarian carcinoma is a devastating disease because patients are diagnosed with advanced disease at presentation and five-year survival ranges from 5-20%. Salvage therapy becomes important for survival in those patients with recurrent disease. There are a variety of agents with relatively similar response rates; however, side effects may limit choice. Pegylated liposomal doxorubicin was found to be less toxic but as effective as other agents. Cardiotoxicity continues to be a concern with long-term antracycline use.

We present three cases of women diagnosed with advanced ovarian carcinoma. Each patient initially underwent optimal cytoreductive surgery, however, developed recurrent disease and were treated with pegylated liposomal doxorubicin. One patient remains disease-free following complete response. Two patients were maintained on pegylated liposomal doxorubicin with stable disease for 18 and 34 months, respectively. These cases demonstrate that pegylated liposomal doxorubicin can be used for extended periods of time without cardiotoxicity.

The adverse events were few with cumulative doses as high as 1,360 mg/m2. These cases show that pegylated liposomal doxorubicin may be a promising agent in recurrent ovarian carcinoma. We recognize the limitations of our data. The results need to be confirmed in a larger group of patients.