TY - JOUR
T1 - Pegylated liposomal doxorubicin-associated hand-foot syndrome
T2 - Recommendations of an international panel of experts
AU - von Moos, Roger
AU - Thuerlimann, Beat J K
AU - Aapro, Matti
AU - Rayson, Daniel
AU - Harrold, Karen
AU - Sehouli, Jalid
AU - Scotte, Florian
AU - Lorusso, Domenica
AU - Dummer, Reinhard
AU - Lacouture, Mario E.
AU - Lademann, Jürgen
AU - Hauschild, Axel
PY - 2008/4
Y1 - 2008/4
N2 - Background: Hand-foot syndrome (HFS) is dose-limiting and the most common cumulative toxicity associated with pegylated liposomal doxorubicin (PLD). It can cause considerable discomfort and lead to therapy interruption. Numerous approaches to HFS management have been reported, but there is no consensus. Methods: Published literature (identified via Medline and internet search) and expert experience regarding HFS and its pathogenesis, incidence, risk factors, prevention and treatment in patients undergoing treatment with PLD were collected and reviewed by a panel of experts. A consensus technique was used to develop recommendations. Findings: The pathogenesis of PLD-associated HFS has been recently elucidated. Systems used to grade, prevent and treat HFS in individuals treated with PLD vary widely. A randomised clinical study demonstrated that PLD dose intensity reduction can prevent HFS. While there is limited literature support, patient education and supportive measures were endorsed by the expert panel as effective strategies for HFS prevention and treatment. An easy to use HFS grading and management algorithm was developed, early signs and symptoms of HFS outlined and specific recommendations for supportive care developed. Interpretation: The paucity of data on the management of PLD-associated HFS led the expert panel to develop consensus-based recommendations. Patient education and supportive measures are important elements in the management of HFS and dose intensity reduction has documented efficacy in prevention. At a PLD dose intensity not exceeding 10 mg/m2 weekly, HFS can be easily managed. Phase III research to support the efficacy other interventions is lacking.
AB - Background: Hand-foot syndrome (HFS) is dose-limiting and the most common cumulative toxicity associated with pegylated liposomal doxorubicin (PLD). It can cause considerable discomfort and lead to therapy interruption. Numerous approaches to HFS management have been reported, but there is no consensus. Methods: Published literature (identified via Medline and internet search) and expert experience regarding HFS and its pathogenesis, incidence, risk factors, prevention and treatment in patients undergoing treatment with PLD were collected and reviewed by a panel of experts. A consensus technique was used to develop recommendations. Findings: The pathogenesis of PLD-associated HFS has been recently elucidated. Systems used to grade, prevent and treat HFS in individuals treated with PLD vary widely. A randomised clinical study demonstrated that PLD dose intensity reduction can prevent HFS. While there is limited literature support, patient education and supportive measures were endorsed by the expert panel as effective strategies for HFS prevention and treatment. An easy to use HFS grading and management algorithm was developed, early signs and symptoms of HFS outlined and specific recommendations for supportive care developed. Interpretation: The paucity of data on the management of PLD-associated HFS led the expert panel to develop consensus-based recommendations. Patient education and supportive measures are important elements in the management of HFS and dose intensity reduction has documented efficacy in prevention. At a PLD dose intensity not exceeding 10 mg/m2 weekly, HFS can be easily managed. Phase III research to support the efficacy other interventions is lacking.
KW - Hand-foot syndrome
KW - Palmar-plantar erythrodysesthesia
KW - Pegylated liposomal doxorubicin
KW - Recommendations
UR - http://www.scopus.com/inward/record.url?scp=41949089700&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=41949089700&partnerID=8YFLogxK
U2 - 10.1016/j.ejca.2008.01.028
DO - 10.1016/j.ejca.2008.01.028
M3 - Article
C2 - 18331788
AN - SCOPUS:41949089700
VL - 44
SP - 781
EP - 790
JO - European Journal of Cancer
JF - European Journal of Cancer
SN - 0959-8049
IS - 6
ER -