Predictors of new-onset heart failure and overall survival in metastatic breast cancer patients treated with liposomal doxorubicin.
| Title: | Predictors of new-onset heart failure and overall survival in metastatic breast cancer patients treated with liposomal doxorubicin. |
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| Authors: | Szmit S; Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology, Centre of Postgraduate Medical Education, European Health Centre, Borowa 14/18, 05-400, Otwock, Poland. s.szmit@gmail.com.; Grela-Wojewoda A; Clinic of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Kraków, Poland.; Talerczyk M; Department of Oncology, West Pomeranian Oncology Center, Szczecin, Poland.; Kufel-Grabowska J; Chemotherapy Ward, The Greater Poland Cancer Center, Poznan, Poland.; Department of Electroradiology, Poznań University of Medical Sciences, Poznan, Poland.; Streb J; Department of Oncology, Jagiellonian University Medical College, Kraków, Poland.; Smok-Kalwat J; Department of Clinical Oncology, Holy Cross Cancer Center, Kielce, Poland.; Iżycki D; Department of Cancer Immunology, Poznan University of Medical Sciences, Poznan, Poland.; Chmielowska E; Department of Oncology, Oncology Centre, Bydgoszcz, Poland.; Department of Clinical Oncology, Oncologic Hospital, Tomaszów Mazowiecki, Poland.; Wilk M; Department of Oncology, Centre of Postgraduate Medical Education, European Health Centre, Otwock, Poland.; Sosnowska-Pasiarska B; Department of Oncocardiology, Holycross Cancer Center, Kielce, Poland. |
| Source: | Scientific reports [Sci Rep] 2020 Oct 28; Vol. 10 (1), pp. 18481. Date of Electronic Publication: 2020 Oct 28. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : Nature Publishing Group, copyright 2011- |
| MeSH Terms: | Breast Neoplasms/*complications ; Breast Neoplasms/*drug therapy ; Doxorubicin/*analogs & derivatives ; Heart Failure/*complications; Antineoplastic Agents/adverse effects ; Antineoplastic Agents/therapeutic use ; Breast Neoplasms/mortality ; Doxorubicin/adverse effects ; Doxorubicin/therapeutic use ; Heart Failure/chemically induced ; Polyethylene Glycols/adverse effects ; Polyethylene Glycols/therapeutic use ; Aged ; Female ; Humans ; Middle Aged ; Neoplasm Metastasis ; Retrospective Studies ; Risk Factors ; Treatment Outcome |
| Abstract: | Cardiovascular diseases (CVDs) are the major cause of morbidity/mortality among breast cancer (BC) patients. Observation of the daily practice in eight experienced Polish oncology centers was conducted to find all possible predictors of new cases of heart failure (HF) and overall survival (OS) of metastatic BC patients treated with liposomal doxorubicin, taking into account the impact of pre-existing CVDs. HF was the cause of premature discontinuation of liposomal doxorubicin therapy in 13 (3.2%) of 402 patients. The probability of developing HF was higher in women with pre-existing CVDs (HR 4.61; 95%CI 1.38-15.38). Independent of CVDs history, a lower risk of HF was observed in those treated with a cumulative dose of liposomal doxorubicin > 300 mg/m2 (HR 0.14; 95% CI 0.04-0.54) and taxane-naive (HR 0.26; 95% CI 0.07-0.96). Multivariate analysis including the presence of pre-existing CVDs and occurrence of new HF, revealed a liposomal doxorubicin in cumulative doses of > 300 mg/m2 as a beneficial predictor for OS (HR 0.61; 95% CI 0.47-0.78) independently of subsequent chemotherapy (HR 0.72; 95% CI 0.57-0.92) or endocrine therapy (HR 0.65; 95% CI 0.49-0.87). Higher doses of liposomal doxorubicin can decrease mortality in metastatic BC without increasing the risk of HF. The clinical benefit is achieved regardless of pre-existing CVDs and subsequent anticancer therapy. |
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| Substance Nomenclature: | 0 (Antineoplastic Agents); 0 (liposomal doxorubicin); 3WJQ0SDW1A (Polyethylene Glycols); 80168379AG (Doxorubicin) |
| Entry Date(s): | Date Created: 20201029 Date Completed: 20210302 Latest Revision: 20210302 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC7595106 |
| DOI: | 10.1038/s41598-020-75614-4 |
| PMID: | 33116159 |
| Database: | MEDLINE |
Journal Article