Toxicity
Almost all patients reported adverse events. The proportion of grade 1, 2 and 3 events was similar between the two groups, however, there was a greater percentage of grade 4 adverse events in the topotecan group (71% v 17%).r
Haematological toxicity was more frequent and usually grade 3 or 4 in the topotecan treated patients. 90% of patients in the topotecan group experienced haematological adverse events and two thirds of these were grade 3 or 4, which resulted in the use of haemotopoietic growth factors, blood transfusions and dosing modifications when compared with the liposomal doxorubicin arm. Nine (3.8%) patients developed treatment-related sepsis (3 of whom died).r
The most common adverse events in the liposomal doxorubicin arm were hand foot syndrome and stomatitis. These were treated with dose reduction or delay.r
Toxicityr |
Liposomal doxorubicin (%)
(all grades) |
Liposomal doxorubicin (%)
(grades 3 to 4) |
Topotecan (%)
(all grades) |
Topotecan (%)
(grades 3 to 4) |
Neutropenia |
35 |
12 |
81 |
77 |
Anaemia |
36 |
5 |
72 |
28 |
Thrombocytopenia |
13 |
1 |
65 |
34 |
Leukopenia |
36 |
10 |
63 |
50 |
Alopecia |
16 |
1 |
49 |
6 |
PPE* |
49 |
23 |
1 |
0 |
Stomatitis |
40 |
8 |
15 |
0.4 |
* Palmar-plantar erythrodysesthesia (hand foot syndrome)
© Journal of Clinical Oncology 2001