Cancer treatment has been greatly improved by the combined use of targeted therapies and novel biotechnological methods. Regarding the former, pegylated liposomal doxorubicin (PLD) has a preferential accumulation within cancer tumors, thus having lower toxicity on healthy cells. PLD has been implemented in the targeted treatment of sarcoma, ovarian, breast, and lung cancer. In comparison with conventional doxorubicin, PLD has lower cardiotoxicity and hematotoxicity; however, PLD can induce mucositis and palmo-plantar erythrodysesthesia (PPE, hand-foot syndrome), which limits its use. Therapeutical apheresis is a clinically proven solution against early PLD toxicity without hindering the efficacy of the treatment. The present review summarizes the pharmacokinetics and pharmacodynamics of PLD and the beneficial effects of extracorporeal apheresis on the incidence of PPE during chemoradiotherapy in cancer patients.

4th Department of Internal Medicine Haematology Faculty Hospital in Hradec Králové 50005 Hradec Králové Czech Republic

Department of Gynecology and Obstetrics Faculty of Medicine in Hradec Králové Charles University Prague 50003 Hradec Králové Czech Republic

Department of Oncology and Radiotherapy Faculty of Medicine in Hradec Králové Charles University Prague 50003 Hradec Králové Czech Republic

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Pharmaceutics. 2020 Nov 17;12(11):E1103. doi: 10.3390/pharmaceutics12111103. PubMed

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Erratum: Filip, S.; et al. Therapeutic Apheresis, Circulating PLD, and Mucocutaneous Toxicity: Our Clinical Experience through Four Years. Pharmaceutics 2020, 12, 940