Ovarian Cancer Patients/Breast Cancer Patients
Adverse effects reported in 5% of patients include hematological
adverse events such as leucopenia, neutropenia, anemia, thrombocytopenia and
the non hematological adverse events such as palmar-plantar erythrodysesthesia
(all grades), stomatitis (all grades), nausea (all grades), asthenia, vomiting,
rash, alopecia, constipation, anorexia, mucous membrane disorder, diarrhea,
abdominal pain, paresthesia, pain, fever, pharyngitis, dry skin, headache, dyspepsia,
somnolence and skin discolouration.
The adverse effects reported in 1-5% of ovarian cancer
patients are allergic reaction, chills, infection, chest pain, back pain,
enlarged abdomen, malaise, oral moniliasis, mouth ulceration, esophagitis, dysphagia,
peripheral edema, dehydration, myalgia, dizziness, depression, insomnia,
anxiety, dyspnea, increased cough, rhinitis, pruritus, skin disorder,
exfoliative dermatitis, herpes zoster, sweating, conjunctivitis and taste
The adverse effects reported in 1-5% of breast cancer
patients are breast pain, leg cramps, edema, leg edema, peripheral neuropathy,
oral pain, ventricular arrhythmia, folliculitis, bone pain, musculoskeletal pain,
cold sores (non herpetic), fungal infection, epistaxis, upper respiratory tract
infection, bullous eruption, dermatitis, erythematous rash, nail disorder,
scaly skin, lacrimation and blurred vision.
Adverse effects associated with the discontinuation of
treatment are bone marrow suppression, cardiac adverse events, infusion related
reactions, toxoplasmosis, palmar-plantar erythrodysesthesia, pneumonia,
cough/dyspnea, fatigue, optic neuritis, progression of a non-KS tumour and
allergy to penicillins.
Adverse reactions reported in ≥ 5% of patients
include hematological side effects such as neutropenia, anemia,
thrombocytopenia and non hematological side events such as nausea, asthenia,
fever, alopecia, increased alkaline phosphatase, vomiting, hypochromic anemia,
diarrhea, stomatitis and oral moniliasis.
Side effects reported in 1-5% of patients which may be
possibly drug related are headache, back pain, infection, allergic reaction,
chills, chest pain, hypotension, tachycardia, herpes simplex, rash, itching, mouth
ulceration, glossitis, constipation, aphthous stomatitis, anorexia, dysphagia,
abdominal pain, hemolysis, increased prothrombin time, increased SGPT, weight
loss, hypocalcemia, hyperbilirubinemia, hyperglycemia, dyspnea, albuminuria,
pneumonia, retinitis, emotional lability, dizziness and somnolence.
Although no formal studies have been done with liposomal
doxorubicin, caution should be exercised in the concomitant use of drugs known
to interact with the conventional form of doxorubicin.
Liposomal doxorubicin, like other doxorubicin
hydrochloride preparations, may potentiate the toxicity of other anticancer
therapies. During clinical trials in patients with solid tumors (including
breast and ovarian cancer) who have received concomitant cyclophosphamide or
taxanes, no new additive toxicities were noted.
Exacerbation of cyclophosphamide induced hemorrhagic
cystitis and enhancement of hepatotoxicity of 6-mercaptopurine have also been
reported with standard doxorubicin hydrochloride.
Caution is also advised when giving any other cytotoxic
agents especially myelotoxic agents at the same time.