Liposomal doxorubicin (CaelyxR) in symptomatic androgen-independent prostate cancer (AIPC): Delayed response and flare phenomenon should be considered

Background : Compared with the native drug, liposomal PEG-coated doxorubicin (Caelyx R ) enhances tumour activity and reduces toxicity. The formulation may therefore be beneficial in anthracycline-sensitive malignancies, where toxicity represents a major problem, as is the case in androgen-insensitive prostate cancer (AIPC). Methods : In a multi-centre design 28 patients with advanced AIPC received Caelyx 40 mg/m 2 as a 1-hour infusion every month. PSA-based biochemical and subjective response was recorded. Results : Three patients had biochemical responses, a subjective response was recorded in a fourth patient. No Grade 4 toxicity was encountered. Three patients developed a spontaneously recovering plantar-palmar erythema. In 3 of the 4 responding patients, the nadir PSA value was noted after 12 and 16 weeks, respectively. A possible flare phenomenon for PSA was evident in 4 patients. Conclusion : Caelyx R has limited activity in advanced AIPC. Due to its low toxicity profile the drug may be a worthwhil...