Anthracyclines in the treatment of gynecologic malignancies Journal Article


Authors: Maluf, F. C.; Spriggs, D.
Article Title: Anthracyclines in the treatment of gynecologic malignancies
Abstract: Objective. The purpose of this article is to present a summary of the pharmacology of anthracyclines as well as to review the results of clinical trials including patients with gynecologic malignancies treated with anthracycline-based therapy. Methods. We performed a MEDLINE literature search of relevant clinical trials for the scope of this review that evaluated anthracycline-based therapy in gynecologic malignancies. Results. Doxorubicin has established activity in carcinomas that arise in the ovary, uterine cervix, and endometrium as well as in uterine sarcomas. However, doxorubicin has structural characteristics that limit its efficacy and safety. Newer anthracyclines with distinct structure, pharmacokinetics, pharmacodynamics, and toxicity profiles have been developed to overcome the limitations of doxorubicin and to further exploit the activity of anthracyclines. Epirubicin is characterized by a structural formula that confers similar cytotoxic antitumor activity with fewer associated side effects than its analogue. Most recently, pegylated liposomal formulations, with distinct pharmacokinetic properties and a favorable toxicity profile, have shown antitumor activity as salvage therapy in ovarian cancer. Intraperitoneal mitoxantrone is also associated with activity in ovarian cancer; however, its clinical use is limited by the severity of local adverse effects. Conclusions. The role of anthracyclines in the management of advanced gynecologic malignancies is important as part of first-line therapy or as a salvage approach. Newer anthracycline agents such as epirubicin and pegylated liposomal doxorubicin are associated with a more favorable toxicity profile. Clinical trials are under way to further explore the role of newer anthracycline-based regimens as first-line or salvage treatment in gynecologic malignancies. © 2002 Elsevier Science (USA).
Keywords: cancer chemotherapy; cancer survival; treatment outcome; unclassified drug; major clinical study; clinical trial; review; cisplatin; doxorubicin; cancer combination chemotherapy; drug efficacy; drug safety; skin toxicity; antineoplastic agents; paclitaxel; endometrial cancer; antineoplastic agent; endometrium cancer; ovarian cancer; carboplatin; ovary cancer; phase 2 clinical trial; cyclophosphamide; antineoplastic activity; docetaxel; genital neoplasms, female; gastrointestinal toxicity; uterine cervix cancer; mitoxantrone; epirubicin; phase 3 clinical trial; phase 1 clinical trial; taxane derivative; anthracycline; anthracyclines; antineoplastic antibiotic; gynecologic cancer; meta analysis; clinical trials; drug induced disease; uterine cancer; bone marrow toxicity; drug formulation; pegylated liposomal doxorubicin; cervix cancer; anthracycline antibiotic agent; humans; human; female; priority journal
Journal Title: Gynecologic Oncology
Volume: 85
Issue: 1
ISSN: 0090-8258
Publisher: Elsevier Inc.  
Date Published: 2002-04-01
Start Page: 18
End Page: 31
Language: English
DOI: 10.1006/gyno.2001.6355
PUBMED: 11925115
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 14 November 2014 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Fernando Maluf
    10 Maluf
  2. David R Spriggs
    325 Spriggs