Topical DMSO treatment for pegylated liposomal doxorubicin-induced palmar-plantar erythrodysesthesia

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Abstract

Purpose: Chemotherapeutic regimens that utilize fluorouracil, cytarabine, and doxorubicin have been shown to cause a dermatologic syndrome known as hand-foot syndrome, or palmar-plantar erythrodysesthesia syndrome (PPES). Pegylated liposomal doxorubicin has proven effective in the treatment of AIDS-related Kaposi's sarcoma, ovarian cancer refractory to platinum and paclitaxel therapies, and metastatic breast cancer. In a study of the treatment of refractory epithelial cell ovarian cancers with lipozomal doxorubicin utilizing intravenous doses of 50 mg/m2 every 3 weeks, grade 3 PPES was observed in 29% of patients (10/35) and required dose reductions and/or dose delay after a median of three therapy cycles. Methods: Current methods to prevent pegylated liposomal doxorubicin-induced PPES include dose reduction, lengthening of the drug administration interval and ultimately, drug withdrawal. Topical 99% dimethylsulfoxide (DMSO) also has shown strong activity in treating tissue extravasation reactions during intravenous administration of doxorubicin. Results: Two patients undergoing chemotherapy with pegylated liposomal doxorubicin, 50 mg/m2 every 4 weeks, developed grade 3 PPE after three cycles. Their PPES resolved over a period of 1 to 3 weeks while receiving topical 99% DMSO four times daily for 14 days. Conclusions: While these results are promising, patients must be treated in a prospective study of this topical DMSO formulation to definitively document its therapeutic efficacy.

Original languageEnglish (US)
Pages (from-to)303-306
Number of pages4
JournalCancer Chemotherapy and Pharmacology
Volume44
Issue number4
DOIs
StatePublished - 1999

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Dimethyl Sulfoxide
Doxorubicin
Refractory materials
Chemotherapy
Cytarabine
Paclitaxel
Platinum
Fluorouracil
Pharmaceutical Preparations
Hand-Foot Syndrome
Therapeutics
Tissue
Intravenous Administration
Ovarian Neoplasms
Epithelial Cells
liposomal doxorubicin
Prospective Studies
Breast Neoplasms
Drug Therapy

Keywords

  • Chemotherapy
  • Dimethylsulfoxide
  • Palmar-plantar dysesthesia

ASJC Scopus subject areas

  • Cancer Research
  • Pharmacology
  • Oncology

Cite this

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title = "Topical DMSO treatment for pegylated liposomal doxorubicin-induced palmar-plantar erythrodysesthesia",
abstract = "Purpose: Chemotherapeutic regimens that utilize fluorouracil, cytarabine, and doxorubicin have been shown to cause a dermatologic syndrome known as hand-foot syndrome, or palmar-plantar erythrodysesthesia syndrome (PPES). Pegylated liposomal doxorubicin has proven effective in the treatment of AIDS-related Kaposi's sarcoma, ovarian cancer refractory to platinum and paclitaxel therapies, and metastatic breast cancer. In a study of the treatment of refractory epithelial cell ovarian cancers with lipozomal doxorubicin utilizing intravenous doses of 50 mg/m2 every 3 weeks, grade 3 PPES was observed in 29{\%} of patients (10/35) and required dose reductions and/or dose delay after a median of three therapy cycles. Methods: Current methods to prevent pegylated liposomal doxorubicin-induced PPES include dose reduction, lengthening of the drug administration interval and ultimately, drug withdrawal. Topical 99{\%} dimethylsulfoxide (DMSO) also has shown strong activity in treating tissue extravasation reactions during intravenous administration of doxorubicin. Results: Two patients undergoing chemotherapy with pegylated liposomal doxorubicin, 50 mg/m2 every 4 weeks, developed grade 3 PPE after three cycles. Their PPES resolved over a period of 1 to 3 weeks while receiving topical 99{\%} DMSO four times daily for 14 days. Conclusions: While these results are promising, patients must be treated in a prospective study of this topical DMSO formulation to definitively document its therapeutic efficacy.",
keywords = "Chemotherapy, Dimethylsulfoxide, Palmar-plantar dysesthesia",
author = "Lopez, {Ana Maria} and L. Wallace and Dorr, {Robert T} and M. Koff and Hersh, {Evan M} and Alberts, {David S}",
year = "1999",
doi = "10.1007/s002800050981",
language = "English (US)",
volume = "44",
pages = "303--306",
journal = "Cancer Chemotherapy and Pharmacology",
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TY - JOUR

T1 - Topical DMSO treatment for pegylated liposomal doxorubicin-induced palmar-plantar erythrodysesthesia

AU - Lopez, Ana Maria

AU - Wallace, L.

AU - Dorr, Robert T

AU - Koff, M.

AU - Hersh, Evan M

AU - Alberts, David S

PY - 1999

Y1 - 1999

N2 - Purpose: Chemotherapeutic regimens that utilize fluorouracil, cytarabine, and doxorubicin have been shown to cause a dermatologic syndrome known as hand-foot syndrome, or palmar-plantar erythrodysesthesia syndrome (PPES). Pegylated liposomal doxorubicin has proven effective in the treatment of AIDS-related Kaposi's sarcoma, ovarian cancer refractory to platinum and paclitaxel therapies, and metastatic breast cancer. In a study of the treatment of refractory epithelial cell ovarian cancers with lipozomal doxorubicin utilizing intravenous doses of 50 mg/m2 every 3 weeks, grade 3 PPES was observed in 29% of patients (10/35) and required dose reductions and/or dose delay after a median of three therapy cycles. Methods: Current methods to prevent pegylated liposomal doxorubicin-induced PPES include dose reduction, lengthening of the drug administration interval and ultimately, drug withdrawal. Topical 99% dimethylsulfoxide (DMSO) also has shown strong activity in treating tissue extravasation reactions during intravenous administration of doxorubicin. Results: Two patients undergoing chemotherapy with pegylated liposomal doxorubicin, 50 mg/m2 every 4 weeks, developed grade 3 PPE after three cycles. Their PPES resolved over a period of 1 to 3 weeks while receiving topical 99% DMSO four times daily for 14 days. Conclusions: While these results are promising, patients must be treated in a prospective study of this topical DMSO formulation to definitively document its therapeutic efficacy.

AB - Purpose: Chemotherapeutic regimens that utilize fluorouracil, cytarabine, and doxorubicin have been shown to cause a dermatologic syndrome known as hand-foot syndrome, or palmar-plantar erythrodysesthesia syndrome (PPES). Pegylated liposomal doxorubicin has proven effective in the treatment of AIDS-related Kaposi's sarcoma, ovarian cancer refractory to platinum and paclitaxel therapies, and metastatic breast cancer. In a study of the treatment of refractory epithelial cell ovarian cancers with lipozomal doxorubicin utilizing intravenous doses of 50 mg/m2 every 3 weeks, grade 3 PPES was observed in 29% of patients (10/35) and required dose reductions and/or dose delay after a median of three therapy cycles. Methods: Current methods to prevent pegylated liposomal doxorubicin-induced PPES include dose reduction, lengthening of the drug administration interval and ultimately, drug withdrawal. Topical 99% dimethylsulfoxide (DMSO) also has shown strong activity in treating tissue extravasation reactions during intravenous administration of doxorubicin. Results: Two patients undergoing chemotherapy with pegylated liposomal doxorubicin, 50 mg/m2 every 4 weeks, developed grade 3 PPE after three cycles. Their PPES resolved over a period of 1 to 3 weeks while receiving topical 99% DMSO four times daily for 14 days. Conclusions: While these results are promising, patients must be treated in a prospective study of this topical DMSO formulation to definitively document its therapeutic efficacy.

KW - Chemotherapy

KW - Dimethylsulfoxide

KW - Palmar-plantar dysesthesia

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