Place of pegylated liposomal doxorubicin in the therapy of metastatic breast cancer

The review deals with trials of pegylated liposomal doxorubicin (PLD) used to treat metastatic breast cancer (mBC), including first-line monotherapy, maintenance therapy, combinations with other cytostatics, trastuzumab regimens for a HER-2-positive subvariant, and rescue therapy for intensively pretreated forms of the disease. PLD is shown to be highly competitive with conventional anthracyclines in efficacy and to greatly surpass them in safety particularly in patients at high cardiac risk; the lack of cumulative toxicity and maximum allowable dose makes it possible to perform therapy until the disease progresses, to use the drug as a support, and to effectively and safely combine PLD with trastuzumab in HER-2-positive mBC. A clinical benefit from the administration of PLD does not depend on susceptibility to anthracyclines. The drug is also an important treatment option for taxane-refractory mBC.