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Thread: Have you dealt with cardiotoxcicity concerns from chemo - doxorubicin, etc.

  1. #1
    Senior User
    Join Date
    Sep 2016
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    310

    Have you dealt with cardiotoxicty concerns from chemo - doxorubicin, etc.

    Hello,

    I am wondering if anyone here has dealt with cardiotoxicity concerns from Doxorubicin/Adriamycin, etc. These drugs have a lifetime limit over which they start worrying about the effects to the heart and don't like to go over 300 mg/m2 lifetime.

    In brief, my son was misdiagnosed with a T-Cell cancer and given the chemo regimine for that cancer (CHOP, which contains doxorubicin), relapsed and had another biopsy which showed the misdiagnosis - it's actually Hodgkin's. The biggest issue is the gold standard regimine for Hodgkin's (80-90% cure rate) also contains doxorubicin. Together, he would be over the lifetime cap and they are telling us he can't have ABVD as it would be about 600 (total for both). But we're not going down without a fight!

    I have been researching possible ways to mitigate the cardiotoxic effects of Doxorubicin and most of the studies are on breast cancer, so I wanted to post here to see if anyone has dealt with this and might have some insight. Here's what I found:

    1) Pegylated Doxirubicin (Doxil) is well studied and much less cardiotoxic, but confers a 50% chance of Chemotherapy-induced acral erythema also known as palmar-plantar erythrodysesthesia or foot and hand sydrome, while generally resolves in 2-3 weeks after stopping chemo, it can be totally debilitating. Myocet is a liposomal preparation that is not pegylated and does not have that side effect but unfortunately it is only approved in Canada and Europe! 2) Alternate scheduling techniques such as in-hospital slow continuous drip over 48 hours reduces cardiotoxicity but is impractical and expensive 3) Cardioprotective drugs such as Doxrazoxane.

    Would greatly appreciate any insight if anyone has dealt with this concern.

    Thanks so much - VMarie
    Last edited by VMarie; 06-16-2017 at 04:46 PM.
    Researcher, advocate, and caregiver to my son, age 24 at diagnosis
    July 2016 Diagnosis ALCL ALK-neg
    Sept 2016 E-CHOP x3; PET scan CR
    Nov 2016 Sixth and final round of E-CHOP completed - Continued to live alone and work two jobs through chemo!
    Dec 2016 PET scan CR
    March 2017 Experiencing symptoms; CT-PET scan shows relapse.
    April 2017 CD-30 confirmed w/ biopsy; Begin Brentuximab to reach CR for Auto transplant
    May 2017 Biopsy came back as Classical Hodgkin's - misdiagnosed initially
    June 2017 Only partial remission with Brent so on to ICE x 2 (worst yet)
    August 2017 Good response, but still PR, moving forward with ASCT. Outpatient at CBCI in Denver.
    October 2017 Clear scan after auto. Begin Brent for maintenance X3
    January 2018 PET-CT shows relapse. Begin Keytruda in Feb
    May 2018 CR after just one dose of Keytruda.
    Scan in August, 2018. ALL CLEAR

  2. #2
    Moderator Top User jorola's Avatar
    Join Date
    May 2014
    Posts
    1,739
    Sorry no one has replied VMarie.

    I personally do not have knowledge or experience with this but thought maybe if I bump the thread it might be seen by someone for you.

    Any update from you on this?

    Jodie
    Wife to husband with squamous lung cancer stage 3 b
    dx - April 20/14
    tx started May 20/14 - radiation and chemo
    June 23 - chemo finished
    July 4 - radiation finished
    July 8 - PET scan shows tumor almost gone, lymph nodes back to normal
    Married July 19/14
    Sept 9/14 - repeat can shows tumor continues to shrink more, no new spots. New coughing and pain due to chest infection or side effect of radiation.
    Sept 19/14 - not infection but pneumonitis, place on dex for 4 weeks
    Oct 22/14 - now off of dex and facing even more symptoms of withdrawal
    Dec 16/14 - pretty much nothing left but a scar
    April 7/15 - ditto scan and screw you stats
    Oct 6/15 - more scarring but still cancer still gone
    Feb 2016 -scan the same
    Aug 2016 - more of the same
    Aug 2017 - and ditto
    Aug 2018 - 4 yrs NED - no evidence of disease
    Aug 2019 - 5 yrs NED and discharged from cancer clinic!!!!!

  3. #3
    Senior User
    Join Date
    Sep 2016
    Posts
    310
    HI Jodie

    Thank you for respsonding. I noticed this board isn't very active. We've actually gone a different direction with chemo and no longer have this particular concern. -VMarie
    Researcher, advocate, and caregiver to my son, age 24 at diagnosis
    July 2016 Diagnosis ALCL ALK-neg
    Sept 2016 E-CHOP x3; PET scan CR
    Nov 2016 Sixth and final round of E-CHOP completed - Continued to live alone and work two jobs through chemo!
    Dec 2016 PET scan CR
    March 2017 Experiencing symptoms; CT-PET scan shows relapse.
    April 2017 CD-30 confirmed w/ biopsy; Begin Brentuximab to reach CR for Auto transplant
    May 2017 Biopsy came back as Classical Hodgkin's - misdiagnosed initially
    June 2017 Only partial remission with Brent so on to ICE x 2 (worst yet)
    August 2017 Good response, but still PR, moving forward with ASCT. Outpatient at CBCI in Denver.
    October 2017 Clear scan after auto. Begin Brent for maintenance X3
    January 2018 PET-CT shows relapse. Begin Keytruda in Feb
    May 2018 CR after just one dose of Keytruda.
    Scan in August, 2018. ALL CLEAR

  4. #4
    Newbie New User
    Join Date
    Jul 2017
    Posts
    3
    I had it as part of my cocktail. It did cause damage. I am 5 years out from chemo and have to take beta blocker and AVE inhibitor. I used to do 30 mins on the treadmill daily and now can only walk a couple blocks. If my cancer returns, I cannot take it again. My cardiologist said it will damage, it's just a matter of how much.

 

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