BACKGROUND: Systemic treatment with pegylated liposomal doxorubicin is an established second-line treatment of advanced cutaneous T-cell lymphoma. Pegylated liposomal doxorubicin (PLD) is currently unavailable, therefore, clinical studies investigating the efficacy of non-pegylated liposomal formula (NPLD) have been analyzed.
METHODS: Since clinical trials comparing PLD and NPLD in CTCL do not exist, the clinical use of NPLD including safety and efficiency profile in other types of non-Hodgkin lymphoma were analyzed.
RESULTS: Clinical trials show a comparable efficacy of NPLD and PLD in non-Hodgkin lymphoma. The dosage of NPLD used in the treatment of systemic lymphoma within polychemotherapy regimens was 50 mg/m2 every three weeks. Overall response was 75-95%, including a complete remission rate of 65-80% and 2- and 3-year overall survival rates of 55-75%. These data indicate that the non-pegylated formula of doxorubicin has a similar antitumor effect as the pegylated one but shows reduced cardiotoxicity. The palmoplantar erythrodysesthesia frequently observed in PLD has not been observed with the use of the NPLD.
CONCLUSIONS: The clinical use of NPLD in the treatment of CTCL is reasonable. In analogy to the clinical trials of NPLD in non-Hodgkin lymphoma a dosage of 50 mg/m(2) every three weeks is recommended for the treatment of CTCL.