Cancer Chemotherapy and Pharmacology

, Volume 44, Issue 4, pp 303–306

Topical DMSO treatment for pegylated liposomal doxorubicin-induced palmar-plantar erythrodysesthesia

  • A. M. Lopez
  • L. Wallace
  • R. T. Dorr
  • M. Koff
  • E. M. Hersh
  • D. S. Alberts
ORIGINAL ARTICLE

Abstract

Purpose: Chemotherapeutic regimens that utilize fluorouracil, cytarabine, and doxorubicin have been shown to cause a dermatologic syndrome known as hand-foot syndrome, or palmar-plantar erythrodysesthesia syndrome (PPES). Pegylated liposomal doxorubicin has proven effective in the treatment of AIDS-related Kaposi's sarcoma, ovarian cancer refractory to platinum and paclitaxel therapies, and metastatic breast cancer. In a study of the treatment of refractory epithelial cell ovarian cancers with lipozomal doxorubicin utilizing intravenous doses of 50 mg/m2 every 3 weeks, grade 3 PPES was observed in 29% of patients (10/35) and required dose reductions and/or dose delay after a median of three therapy cycles. Methods: Current methods to prevent pegylated liposomal doxorubicin-induced PPES include dose reduction, lengthening of the drug administration interval and ultimately, drug withdrawal. Topical 99% dimethylsulfoxide (DMSO) also has shown strong activity in treating tissue extravasation reactions during intravenous administration of doxorubicin. Results: Two patients undergoing chemotherapy with pegylated liposomal doxorubicin, 50 mg/m2 every 4 weeks, developed grade 3 PPE after three cycles. Their PPES resolved over a period of 1 to 3 weeks while receiving topical 99% DMSO four times daily for 14 days. Conclusions: While these results are promising, patients must be treated in a prospective study of this topical DMSO formulation to definitively document its therapeutic efficacy.

Key words Chemotherapy Palmar-plantar dysesthesia Dimethylsulfoxide 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1999

Authors and Affiliations

  • A. M. Lopez
    • 1
  • L. Wallace
    • 3
  • R. T. Dorr
    • 3
  • M. Koff
    • 3
  • E. M. Hersh
    • 1
  • D. S. Alberts
    • 1
  1. 1.Department of Medicine, College of Medicine, University of Arizona, Tucson, AZ 85724, USAUS
  2. 2.Department of Pathology, College of Medicine, University of Arizona, Tucson, AZ 85724, USAUS
  3. 3.Arizona Cancer Center, College of Medicine, University of Arizona, P.O. Box 245024, Tucson, AZ 85724, USA Tel. +1-520-626-7685; Fax +1-520-626-2445US
  4. 4.Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ 85724, USAUS
  5. 5.Department of Toxicology, College of Medicine, University of Arizona, Tucson, AZ 85724, USAUS

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