396P - Use of liposomal doxorubicin for metastatic breast cancer management across Europe: Results of EOS (European Observatory & Survey)

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer Agents
Breast Cancer
Biological Therapy
Presenter Vito Lorusso
Citation Annals of Oncology (2014) 25 (suppl_4): iv116-iv136. 10.1093/annonc/mdu329
Authors V. Lorusso1, A. Śmiałowska-Janiszewska2, K. Krzemieniecki3, S. Antolín Novoa4, F. Mefti5, J. Janssen6, G.G. Steger7, B. Bird8, M. Turazza9, H. Yosef10, E. Albuisson11, A. Barnadas12, G. Batist13, J. De Mouzon14, F. Erdkamp15, R. Leonard16, M. Namer17, S. Maumus-Robert18, M.S. Aapro19
  • 1Oncology, National Cancer Research Centre Giovanni Paolo II, 70124 - Bari/IT
  • 2Department Of Chemotherapy, Copernicus Memorial Hospital Regional Cancer Center, Paderewskiego/PL
  • 3Oncology, M. Sklodowska- Curie Oncology Center, Krakow/PL
  • 4Medical Oncology Unit, A Coruña University Hospital, A Coruña/ES
  • 5Medical Oncology Unit, Hôpital René HUGUENIN, Saint-Cloud/FR
  • 6Medical Oncology Unit, Onkologische Westerstede, Westerstede/DE
  • 7Division Of Oncology And Comprehensive Cancer Center, Medical University of Vienna, Vienna/AT
  • 8Medical Oncology Unit, Bon Secours Hospital, Cork/IE
  • 9Medical Oncology Unit, Sacro Cuore Hospital, Negrar/IT
  • 10Acute Service Division, Beatson WOS Cancer Centre, Glasgow/GB
  • 11Département D'information Médicale, Centre Hospitalier Universitaire de Nancy, Nancy/FR
  • 12Medical Oncology, Santa Creu i Sant Pau Hospital, 08041 - BARCELONA/ES
  • 13Oncology, Mcgill University, McGill University, Montreal/CA
  • 14Service De Médecine De La Reproduction, Cochin Hospital, Paris/FR
  • 15Research Unit Hemato-oncology, Orbis Medical Center, NL-6130 MB - Sittard/NL
  • 16Oncology, Imperial College, W68RF - London/GB
  • 17Oncology, Cancer Center / University of Nice, Nice/FR
  • 18Scientific Department, ClinSearch, Bagneux/FR
  • 19-, Clinique de Genolier, 1272 - Genolier/CH



Among the systemic therapeutic options available for metastatic breast cancer (MBC), non-pegylated liposomal doxorubicin (Myocet®, LED) limits anthracycline-related cardiotoxicity. This study aimed to analyse the therapeutic decision for choosing it vs. another chemotherapy drug (n-LED).


A European, multicentre, prospective, observational study comparing at baseline LED vs. n-LED patients (pts) with confirmed MBC and scheduled 1st cycle of chemotherapy was performed in 8 countries (Austria, France, Germany, Ireland, Italy, Poland, Spain, United Kingdom). LED and n-LED pts were matched on centre, MBC chemotherapy line and time (comparisons used univariate logistic regression).


1544 pts (772 in each group) were analysed (median age: 60 yrs; WHO performance status 0-1: 84%; HER2+ at initial diagnosis: 26%). 45% of both groups had 1st line therapy. LED was mainly given alone (39%), or combined with cyclophosphamide only (47%). 62% n-LED pts received monotherapy. Most of pts' clinical and disease characteristics were similar in both groups. However, HER2+ was less frequent in LED group (22% vs. 29%, p < 0.001), particularly in France (13% vs. 23%, p = 0.02) and Italy (16% vs. 35%, p < 0.01). Previous anthracycline use was less frequent in LED (55% vs. 62%, p < 0.01), particularly in Germany and Italy (p = 0.02 and p < 0.001, respectively). In Germany, patients ≥ 70 yrs were more frequent in LED group (29% vs. 16%, p < 0.01). In parallel, among the reasons given by physicians for therapeutic choice, increased cardiac risk was more frequent in LED (58% vs. 35%, p < 0.001). Regarding safety of prescribed chemotherapy, cardiac safety reason was more frequently reported in LED (91% vs. 69%, p < 0.001). Moreover, the chosen treatment was more often reported as the reference approach in institution for the specific pt's profile in n-LED group (92% vs. 75%, p < 0.001), notably in Poland (91% vs. 59%, p < 0.001) and France (94% vs. 75%, p < 0.02).


Even if the decision to use LED was not fully explained, some differences emerge across countries reflecting local specificities in MBC management. Cardiac risk remains the first motivation for oncologists to choose LED.


G.G. Steger: Honoraria and travel grants from Cephalon and TEVA/Ratiopharm; H. Yosef: I acted as a member of advisory boards for Myocet; E. Albuisson: I receive remuneration from Cephalon France as expert member of the EOS Study Steering Committee; G. Batist: I have no financial interest in products or processes involved in my research, including stock ownership. I have served on Advisory Boards of Sanofi and Roche, each once in past year. I have investigator-initiated grants, with Pfizer, Bayer.; J. De Mouzon: I have been a compensated consultant for EOS study for protocol. I have no other conflict of interest; S. Maumus-Robert: I am an employee of ClinSearch, a contract research organisation which was contracted by Cephalon France/TEVA for the set up and management of the EOS study; M.S. Aapro: Dr Aapro is/was consultant & received lecture honoraria: Amgen/GSK/Helsinn/Hospira/Novartis/Merck/Merck Serono/Pfizer/Pierre; Fabre/Roche/Sandoz/Teva/Vifor; is/was consultant: Astellas/BMS/Celgene/Pharmacosmos; received lecture honoraria: Sanofi Aventis. All other authors have declared no conflicts of interest.