Predictors of new-onset heart failure and overall survival in metastatic breast cancer patients treated with liposomal doxorubicin.

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.

Left ventricular systolic dysfunction in metastatic breast cancer patients: a Polish multicenter registry.

BACKGROUND: The knowledge of the epidemiology of left ventricular systolic dysfunction (LVSD) in relationship with cardiovascular diseases, their risk factors and history of previous anticancer therapy may lead to development of safer and more effective therapeutic strategies in patients with breast cancer (BC). PATIENTS AND METHODS: Oncologists from various Polish Centers reported 299 new cases of metastatic BC requiring chemotherapy. All registered previous cardiological and oncological therapies should be conducted in accordance with the mandatory guidelines. RESULTS: Twelve new cases (4%) of LVSD were recognized in echocardiography before current chemotherapy. Multivariate logistic regression analysis revealed a significant association of LVSD with hypercholesterolemia (odds ratio (OR)=8.83; 95% confidence interval (CI)=1.44-54.16; p<0.02), prior myocardial infarction (OR=26.81; 95%CI=2.26-318.43; p<0.01), prior antracycline-based therapy either neoadjuvant (OR=13.21; 95%CI=2.18-80.12, p=0.005) or adjuvant (OR=6.94; 95%CI=1.003-47.985, p<0.05). CONCLUSION: LVSD in metastatic BC reflects common negative effects of hypercholesterolemia, coronary events and neoadjuvant/adjuvant chemotherapy with anthracyclines.

Selenium as an element in the treatment of ovarian cancer in women receiving chemotherapy.

OBJECTIVE: Our objective is to examine how selenium (Se) supplementation influences oxidative stress (malondialdehyde) and the glutathione peroxidase system in patients with ovarian cancer undergoing chemotherapy. MATERIAL: The study group included 31 patients with ovarian cancer undergoing chemotherapy receiving the drug Protecton Zellactiv (Smith Kline Beecham, Fink Naturarznei GmbH, Germany), two capsules, four times daily (200 microg). RESULTS: Following the Se supplementation in a daily dose of 200 microg, the concentration of this microelement in serum (P < 0.05) and hair (P < 0.05) was significantly higher than in the control group. It has also been found that Se concentration in serum was significantly increased after 2 (P < 0.0000) and 3-months' (P < 0.0000) length of supplementation, as compared to the values after 1 month. In the hair of patients receiving this supplementation, an insignificantly higher concentration of this microelement was found after 2 (NS) and 3 months (NS) in comparison to the concentration after 1 month. The patients with ovarian cancer undergoing chemotherapy and receiving Se showed a significant increase in the activity of GSH-P(x) in erythrocytes after 2 months' (P < 0.0015) and 3 months' (P < 0.0038) supplementation. An increase of the concentration of malondialdehyde (MDA) following the administration of Se after 2 months (P < 0.0363) and 3 months (P < 0.0489) was found to be significant. The increase of MDA calculated into platelet count was found to be significant after 3 months (P 0.0477) of Se supplementation. Se administration for 3 months resulted in the significant increase of white blood cells (WBC) (P < 0.0001). After 2 and 3 months of Se administration, a significant decrease of hair loss (P < 0.0000; P < 0.0392, respectively), flatulence (P < 0.0000; P< 0.0000), abdominal pain (P < 0.0006; P < 0.0202), weakness (P < 0.0001; P < 0.0000), malaise (P < 0.0017; P < 0.0000), loss of appetite (P < 0.0000; P < 0.0000) was stated. CONCLUSION: As a result of this clinical trial, we conclude that there are beneficial effects caused by ingesting selenium, as a supportive element in chemotherapy.