文章：

聚乙二醇脂质体阿霉素单药治疗转移性乳腺癌最常见的副作用：临床试验的系统回顾

The most prevalent side effects of pegylated liposomal doxorubicin monotherapy in women with metastatic breast cancer: a systematic review of clinical trials

原文发布日期：2017-04-14 

英文摘要：

Despite benefits of systemic chemotherapy in breast cancer treatment, several patients with early-stage breast cancer will develop metastatic breast cancer (MBC). Doxorubicin is among the most active agents against MBC. However, the use of doxorubicin is related to some life-threatening side effects including cardiotoxicity. Many efforts were made to lessen the side effects of doxorubicin and improve its efficacy. Pegylated liposomal doxorubicin (PLD) is a product claimed to achieve these two objectives because of its different pharmacokinetic profile. The aim of this study was to determine the side-effect profile of PLD in MBC through a systematic review of phase II clinical trials. A literature search in PubMed-MEDLINE was performed using terms covering nano-based pharmaceutical systems, ‘breast cancer’ and ‘doxorubicin’. Articles were evaluated according to the inclusion criteria. Reported hematological and non-hematological side effects were categorized. Out of 718 articles that were initially identified, 8 were in accordance with the inclusion criteria. We found that the most important side effects of PLD were skin toxicity and mucositis, but the proportion of patients who showed grade III and IV of these side effects was relatively low. On the other hand, the occurrence of cardiotoxicity, the most important problem with doxorubicin, was considerably reduced in patients treated with PLD. Although PLD has demonstrated a lower toxicity profile than conventional anthracyclines, it has also new side effects. However, it seems that the reduced cardiotoxicity of PLD has made it a more appropriate option in patients with MBC, especially in those with risk factors for cardiac diseases. 

摘要翻译： 

尽管全身性化疗在乳腺癌治疗中具有益处，但部分早期乳腺癌患者仍会发展为转移性乳腺癌（MBC）。多柔比星是治疗MBC最有效的药物之一，但其使用会导致包括心脏毒性在内的一些危及生命的副作用。为减轻多柔比星的副作用并提高其疗效，学界已付出诸多努力。聚乙二醇化脂质体多柔比星（PLD）因其独特的药代动力学特征，被认为是可实现上述双重目标的产品。本研究旨在通过系统回顾II期临床试验，明确PLD在MBC治疗中的副作用特征。我们在PubMed-MEDLINE数据库中使用涵盖纳米药物系统、"乳腺癌"和"多柔比星"的关键词进行文献检索，并根据纳入标准对文章进行评估，对报告的血液学和非血液学副作用进行分类。在初步筛选的718篇文章中，最终有8篇符合纳入标准。研究发现PLD最主要的副作用是皮肤毒性和黏膜炎，但出现III级和IV级这些副作用的患者比例相对较低。另一方面，多柔比星最严重的心脏毒性问题在使用PLD治疗的患者中显著降低。尽管PLD显示出比传统蒽环类药物更低的毒性特征，但它也带来新的副作用。然而，PLD心脏毒性的降低使其成为MBC患者（尤其是有心脏病风险因素者）更合适的选择。

原文链接：

The most prevalent side effects of pegylated liposomal doxorubicin monotherapy in women with metastatic breast cancer: a systematic review of clinical trials