Pegylated liposomal doxorubicin (Doxil)

Also known as Caelyx or Myocet.

General information

Class/mechanism: Anthracycline; binds and intercalates into DNA, inhibiting nucleotide replication and DNA/RNA polymerase activity. Causes DNA cleavage through interaction with topoisomerase II.

Doxorubicin is encapsulated in long-circulating STEALTH® liposomes, which are microscopic vesicles made of a phospholipid bilayer. The liposomes are pegylated with surface-bound methoxypolyethylene glycol (MPEG) to increase circulation time and protect them from detection by the mononuclear phagocyte system (MPS). Their 100 nm size and long circulation may aid their ability to penetrate the altered vasculature of tumors. Exact mechanism of release of the active drug contained within the liposome is not understood.
Route: IV
Extravasation: irritant

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.

Diseases for which it is used

• Aggressive Non-Hodgkin lymphoma
• Breast cancer
• Esophageal cancer
• HIV-associated lymphoma
• Hodgkin lymphoma
• Multiple myeloma
• Ovarian cancer
• Sarcoma
• Uterine cancer

Patient drug information

• Doxorubicin liposomal (Doxil) patient drug information (Chemocare)
• Brief patient counseling information can be found on page 15 of the Doxorubicin liposomal (Doxil) package insert
• Doxorubicin liposomal (Doxil) patient drug information (UpToDate)