Gynecologic cancer: is routine cardiac testing necessary before PLD?

  • Dioun SM & al.
  • Gynecol Oncol
  • 28 Sep 2019

  • curated by Craig Hicks
  • Univadis Clinical Summaries
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Takeaway

  • Routine cardiac testing before, during, or after treatment with pegylated liposomal doxorubicin (PLD) may not be necessary in patients with gynecologic cancer.

Why this matters

  • The manufacturer recommends evaluations via endomyocardial biopsy, echocardiography, or multigated acquisition scan (MUGA) before and during treatment. Findings suggest testing could be reserved for high-risk patients.

Study design

  • Researchers analyzed the health records of 235 patients (mean age, 62±11 years, 37% black) receiving PLD for gynecologic cancer.
  • A Wilcoxon signed-rank sum test and logistic regression were used to evaluate the association between cumulative PLD exposure with cardiotoxicity.
  • Funding: National Institutes of Health.

Key results

  • Data for 56 patients with both pre- and posttreatment cardiac testing showed no significant difference in median ejection fraction (P=.17).
  • 3 patients experienced PLD-associated cardiac toxicity, but only 1 patient had severe symptoms requiring treatment discontinuation.

Limitations

  • Retrospective, observational data.