HER2 Support Group Forums - View Single Post - low dosage adriamyacin

Lani · 01-24-2008, 12:18 AM

the TOPO IIA test just became FDA approved. If Caryn is TOPOIIA negative, Adriamycin may not be the choice for treatment according to Dr. Slamon's talk at SABCS. His studies are not a slam-dunk (not reconfirmed in thousands of clinical trial patients, just in his BCIRG006 study) but many in attendance seemed to be changing their prescribing practices based on it (judging by how they answered many polls).

Any chance she could get the test?
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When you say her skin was burning from the inside out, was that in an area previously radiated?--there is a phenomenon called "radiation recall dermatitis " when anthracyclines(or other agents) are given after radiation therapy. I will try to look up if decreasing the dose was helpful or if it is more like an allergy to strawberries, where eating less strawberries makes no difference.

a bit more information--
Radiation recall dermatitis is a rare toxic effect induced by several chemotherapeutic agents in patients who have received prior treatment with radiation therapy. The recall phenomenon was initially described as redness, edema, peeling and blistering that occurred in a previously intact skin area corresponding to the field of irradiation after treatment with doxorubicin . It has been subsequently reported in association with gemcitabine , docetaxel, paclitaxel, oxaliplatin and methotrexate, among others.

Doxil or Pegylated liposomal doxorubicin has a markedly distinct toxicity profile from its parent compound, doxorubicin. Whereas cardiotoxicity appears to be reduced, mucosal damage is frequent, and cutaneous toxicity in the form of hand-foot syndrome is dose limiting. It is currently approved for its use as monotherapy in metastatic breast cancer patients who are at increased cardiac risk, in ovarian cancer patients after failure of platinum-based chemotherapy, and in AIDS-related Kaposi's sarcoma.
Recently radiation recall dermatitis was described as being induced by pegylated liposomal doxorubicin, it shows that the addition of a pegylated liposomal coat does not prevent doxorubicin cutaneous toxicity after radiotherapy. Luckily it was successfully managed with high-potency topical steroids.

The article discussing this case warned that the potential cutaneous toxicity must be taken into account considering the increasing use of pegylated liposomal doxorubicin in patients who frequently receive radiation therapy, such as stage IV breast cancer patients.
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Very low dose chemotherapies--much too little to kill the cancer cells given daily--is called metronomic chemotherapy and has been tried in trials because of its antiangiogenic effect.

Just throwing things out there as I am not sure I follow what is being suggested.

Hope some of this disjointed thinking proves useful.

01-24-2008, 12:18 AM	#6
Lani Senior Member Join Date: Mar 2006 Posts: 4,783	eric the TOPO IIA test just became FDA approved. If Caryn is TOPOIIA negative, Adriamycin may not be the choice for treatment according to Dr. Slamon's talk at SABCS. His studies are not a slam-dunk (not reconfirmed in thousands of clinical trial patients, just in his BCIRG006 study) but many in attendance seemed to be changing their prescribing practices based on it (judging by how they answered many polls). Any chance she could get the test? ^^^^^^^^^^^^^^^^^^^^ When you say her skin was burning from the inside out, was that in an area previously radiated?--there is a phenomenon called "radiation recall dermatitis " when anthracyclines(or other agents) are given after radiation therapy. I will try to look up if decreasing the dose was helpful or if it is more like an allergy to strawberries, where eating less strawberries makes no difference. a bit more information-- Radiation recall dermatitis is a rare toxic effect induced by several chemotherapeutic agents in patients who have received prior treatment with radiation therapy. The recall phenomenon was initially described as redness, edema, peeling and blistering that occurred in a previously intact skin area corresponding to the field of irradiation after treatment with doxorubicin . It has been subsequently reported in association with gemcitabine , docetaxel, paclitaxel, oxaliplatin and methotrexate, among others. Doxil or Pegylated liposomal doxorubicin has a markedly distinct toxicity profile from its parent compound, doxorubicin. Whereas cardiotoxicity appears to be reduced, mucosal damage is frequent, and cutaneous toxicity in the form of hand-foot syndrome is dose limiting. It is currently approved for its use as monotherapy in metastatic breast cancer patients who are at increased cardiac risk, in ovarian cancer patients after failure of platinum-based chemotherapy, and in AIDS-related Kaposi's sarcoma. Recently radiation recall dermatitis was described as being induced by pegylated liposomal doxorubicin, it shows that the addition of a pegylated liposomal coat does not prevent doxorubicin cutaneous toxicity after radiotherapy. Luckily it was successfully managed with high-potency topical steroids. The article discussing this case warned that the potential cutaneous toxicity must be taken into account considering the increasing use of pegylated liposomal doxorubicin in patients who frequently receive radiation therapy, such as stage IV breast cancer patients. ^^^^^^^^^^^^^^^^^^^^^^^^^^ Very low dose chemotherapies--much too little to kill the cancer cells given daily--is called metronomic chemotherapy and has been tried in trials because of its antiangiogenic effect. Just throwing things out there as I am not sure I follow what is being suggested. Hope some of this disjointed thinking proves useful.