Improving the therapeutic index when using Myocet™ in the treatment of metastatic breast cancer

Improving the therapeutic index of anthracycline-based regimens in the management of metastatic breast cancer is a goal that physicians strive for in order to improve quality of life and increase the small fraction of long-term disease-free survivors that have been observed in studies using anthracycline-based regimens. There are supporters and opponents of continuous and dose-intensive therapy for improving quality of life and providing a survival advantage, but the risk of cumulative toxicity associated with anthracycline-based regimens, especially, doxorubicin, is limiting in these approaches. Myocet (TM), has equivalent antitumour efficacy to doxorubicin, but significantly less cardiotoxicity. Consequently, the recommended cumulative lifetime dose of Myocet is 780 mg/m(2), compared with 450 mg/m(2) for doxorubicin. By using Myocet in the metastatic setting, and perhaps eventually in the adjuvant treatment for primary breast cancer, an increased number of cycles can be given within the cardiotoxicity risk threshold, improving quality of life by delaying relapse. This improvement in therapeutic index may contribute to the fraction of long-term disease-free survivors and fulfils a previously unmet need in the overall management of breast cancer. (C) 2001 Harcourt Publishers Ltd.