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Prevention of palmoplantar erythrodysesthesia in patients treated with pegylated liposomal doxorubicin (Caelyx®)

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Abstract

Purpose

Palmoplantar erythrodysesthesia (PPE) is one of the most frequent side effects during systemic treatment with pegylated liposomal doxorubicin (PLD, Caelyx®). PPE lesions show a range of symptoms, from numbness to painful erosions, and can have a major impact on the quality of life in affected patients. Previously, a possible pathomechanism of PPE was found in doxorubicin-treated patients based on radical formation in the skin. Here, a preventive strategy using a topically applied ointment with a high radical protection factor was investigated.

Methods

In this randomized placebo-controlled double-blind study the antioxidant-containing ointment was compared with a placebo ointment regarding PPE grade III occurrence, overall PPE grade I–III occurrence and PPE severity in PLD patients. The verum or placebo cream was topically applied for a period of 16 weeks, starting 3 days prior to the first cycle of chemotherapy. Clinical evaluations were carried out by a dermatologist prior to the first cycle of chemotherapy and every 4 weeks for the duration of 16 weeks.

Results

Thirty-two patients were enrolled in total, of which 17 (66%) completed the study. No PPE grade III was found in the verum group, while five out of seven patients (71%) had to be unblinded in the placebo arm due to PPE grade III (p = 0.003). General PPE occurrence of all grades was 60% under verum and 86% under placebo treatment.

Conclusions

The preventive application of an antioxidant-containing ointment was shown to be significantly more effective in the prevention of PPE grade III compared to placebo treatment.

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Author information

Authors and Affiliations

  1. Department of Dermatology, Venerology and Allergology, Center of Experimental and Applied Cutaneous Physiology, Charité – Universitätsmedizin Berlin, Berlin, Germany

    S. Jung, F. Kluschke, A. Patzelt, F. Knorr & J. Lademann

  2. Department of Gynaecology and Obstetrics, Charité – Universitätsmedizin Berlin, Berlin, Germany

    J. Sehouli & R. Chekerov

  3. Department of Hematology, Oncology and Palliative Care, Helios Klinikum Bad Saarow, Bad Saarow, Germany

    H. Fuss

Authors
  1. S. Jung
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  2. J. Sehouli
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  3. R. Chekerov
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  4. F. Kluschke
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  5. A. Patzelt
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  6. H. Fuss
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  7. F. Knorr
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  8. J. Lademann
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Corresponding author

Correspondence to S. Jung.

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Conflict of interest

The study was supported by Medac, Gesellschaft für klinische Spezialpräparate, Wedel, Germany.

J. Lademann: Consulting role in Medac GmbH.

Primary data is available and the authors agree to allow a review of the data upon request.

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Jung, S., Sehouli, J., Chekerov, R. et al. Prevention of palmoplantar erythrodysesthesia in patients treated with pegylated liposomal doxorubicin (Caelyx®). Support Care Cancer 25, 3545–3549 (2017). https://doi.org/10.1007/s00520-017-3781-x

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  • DOI: https://doi.org/10.1007/s00520-017-3781-x

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