Pegylated liposomal doxorubicin in combination with low-dose metronomic cyclophosphamide as preoperative treatment for patients with locally advanced breast cancer

Breast. 2011 Aug;20(4):319-23. doi: 10.1016/j.breast.2011.02.014. Epub 2011 Mar 11.


Aim: To evaluate the role of pegylated liposomal doxorubicin with low-dose metronomic cyclophosphamide as primary systemic treatment in locally advanced breast cancer.

Patients and methods: The activity and safety of intravenous pegylated liposomal doxorubicin 20 mg sqm(-1) biweekly for eight courses in combination with metronomic cyclophosphamide 50 mg day(-1) orally were evaluated in 29 patients with locally advanced breast cancer who were not suitable to receive a standard chemotherapy due to age or co-morbidities or who asked for a regimen with low incidence of toxic effects irrespective of age.

Results: The rate of breast-conserving surgery was 44.8%. Eighteen patients (62.1%) achieved a partial response (including one pathological complete response), 10 (34.5%) a stable disease and one patient experienced a progressive disease. Treatment was well tolerated, with no grade 4 toxicities, and with grade 3 skin toxicity in three patients and hand-foot syndrome in four patients.

Conclusion: The regimen was well tolerated but with limited activity in the preoperative setting. Other options (e.g., endocrine therapy in estrogen receptor -positive disease) should be considered in locally advanced breast cancer patients who are not suitable to receive a standard chemotherapy.

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology*
  • Cyclophosphamide / administration & dosage
  • Dose-Response Relationship, Drug
  • Doxorubicin / administration & dosage
  • Doxorubicin / analogs & derivatives
  • Drug Administration Schedule
  • Female
  • Humans
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Polyethylene Glycols / administration & dosage
  • Premedication*
  • Treatment Outcome


  • liposomal doxorubicin
  • Polyethylene Glycols
  • Doxorubicin
  • Cyclophosphamide