Doxil side effects

PatsieD said:

You
Don't know the answer but have been thinking of you x x

About Doxil
Julie, I had 6 rounds of Doxil in total, given once a month. Unfortunately, in my particular case, the chemo did little to reduce my CA125 levels, so my oncologist decided once again to change the chemotherapy. However, no two patients are the same. What works for one may not work for another, so keep thinking positive.

I know that redness and sores on the hands and feet can be one of the side effects of Doxil. I was lucky enough not to experience this, even though I had those six rounds of treatment. Other patients who did suffer from this told me that they found it helped to put ice packs on their hands and feet during the treatment and also afterwards. Don't know if this will help in your case, but anything is worth a try...right?

Good luck, as always.

Dorothy

JulieL said:

Thank you
Yes. I am going to purchase several icepacks and will take them along with me to my next infusion and hope that might help. Sorry to hear that Doxil didn't work for you but great you are now seeing reduction in CA125. What are you on now? With so many different chemo's and everyone being different it is a matter of trial and error isn't it!

Cheers,
Julie

hey
mom hasn't had that particular reaction yet. She had her second a week ago. She did however really suffer this time. Was very unpleasant. Tons of nausea and pain. Really didn't think these side effects were as horrible as some of the other chemos. Don't know. Good luck Miss.

amartin said:

Doxil side effects

I have had two Doxil treatments, with the third scheduled later this month. The palms of my hands and soles of my feet are burned and blistered. I can barely walk due to the blisters on the bottoms of my feet. My mouth also is sore and I'm having some difficulty swallowing, although these problems aren't as troubling as the burned hands and feet. I am wondering what experience others have had. Did the side effects just continue to get worse with each treatment? If so, I am considering refusing further treatment with Doxil. If the side effects become worse, I won't be able to walk. This situation does not meet my first priority for treatment, which is quality of life.

Amartin~Agree w/u "Quality of Life" has 2B taken N2 acct

Dear AMartin:

Would I be correct in assuming that you have had Cytoreductive Surgery?  You have written on both the Peritoneal and Ovarian links.   So I have taken the liberty of answering you here as well as on the Ovarian site.  There are far fewer people who write on the Primary Peritoneal link. 

Now as for you and whether or not you wish to continue your present regimen of Doxil, that's a big decision to make.  Often oncologists will say, “We have other tools in our box that we can use!”  You might want to ask if your doc has anything else in his/her “tool box”!  You’re not the first one that has had adverse side effects with the use of DOXIL…sore mouth, blisters on feet till they can’t walk, skin peeling on fingers, etc.  Those are symptoms that several have expressed here.  I’ve just mentioned a few of late that are “suffering” side effects from Doxil.  And Avastin doesn’t have a 5-Star rating either! 

“Guitardiva” has had her share of both Doxil and Avastin – Below my name are a few comments from ladies here about the effects of Avastin/Doxil as well as some medical info from clinical trials. 

My chemo combo of Carboplatin/Paclitaxel (Taxol) has had good effects in affording me some extra time, but none were ever intended to be curative.  My last CT scan on September 5, 2017 shows a gradual increase in the size of previous nodes, more pleural effusion, new node on Caudate lobe of liver, plus other things.  My oncologist gave me a list of other “tools” we could “try”, plus some clinical trials.  He mentioned both Doxil and Avastin.  Based on what my “OC sisters” are suffering from those two “tools”, I threw up my hands and said, “No way!”    And if Doxil/Avastin haven’t worked out so well for many others, then why do I want to jump in?  My oncologist explained to me that all the other choices fall in line below the standard recommended treatment for both Peritoneal and Ovarian Cancer which is Carboplatin/Paclitaxel (Taxol).  Now we know that some are resistant to the “platin” family, and have to try something else.  But for the most part, clinical trials have shown that the Carbo/Taxol regimen has worked well for the highest number of women diagnosed with Ovarian Cancer.  He also explained that the others would carry with it a higher level of toxicity for me.  He gave me a list of about 8 options. 

So that’s where I find myself.  Out on a limb and not certain what to do next.  So for now, I’m just “waiting” because I’m not happy about any of the choices.  And I may just opt for some immunotherapy trial—after all, aren’t they all in essence just that—TRIALS?

The old expression, “I’d rather dance with the devil that I do know rather than with the one I don’t know” applies here for me.  Since I’m in the “guinea-pig” category anyway, I’d just as soon climb out on another limb.  But there again, how many pigs survive when they attempt to climb a tree, and go out on a limb?  That’s how I feel as far as “which tool, if any at all, should I choose?”  I don’t consider myself a fatalist, just a realist.  It’s just that I’m not fond of any of the “choices” that I am free to make. 

However, as a woman of faith, I do agree with the Psalmist David’s sentiments in Psalm 139.  I firmly believe in an omniscient, omnipresent and omnipotent God Who watches over me.  I am convinced that I will not die one day sooner than the number of days allotted to me on this earth.  Further, I am grateful for the days afforded me so far since being diagnosed with Peritoneal Carcinomatosis/Ovarian Cancer in November & December of 2012.  It has not been without many “trials”.  But when I last checked the definition of “terminal”, it did indicate a cessation of activities at some point.  My ultimate destination is Heaven, so why should I expect “Heaven on Earth?”  I am constantly praying that the Lord will lay on my heart which decision to make, as well as guide my oncologist in advising me along the way.

I absolutely agree with you that “Quality of Life” takes priority over “Quantity of Life.”  All the while remembering that… “Life isn’t about waiting for the storm to pass—It’s about learning how to dance in the rain.” Now that’s not to say thatI signed up for this course.  I do find the slippers pinch my toes quite often!

 Loretta

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1.       https://csn.cancer.org/comment/1589259#comment-1589259  “Guitardiva” stopping Doxil/Avastin because of such severe side effects

2.       https://csn.cancer.org/node/310562 - Pattie asking about Doxil/Avastin

3.      https://csn.cancer.org/node/311458 -   advantages vs. Disadvantages of AVASTIN

4.      https://csn.cancer.org/comment/1590482#comment-1590482 – Severe blistering

5.      https://csn.cancer.org/node/206203   Carole’s experience with Avastin

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6.       http://www.webmd.com/cancer/cervical-cancer/news/20140219/avastin-shows-mixed-results-against-different-cancers?page=2

“Avastin: Mixed Results against Different Cancers…”

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7.      http://www.medpagetoday.com/MeetingCoverage/SGO/50720?xid=nl_mpt_DHE_2015-03-31&eun=g67937d0r&userid=67937&mu_id=5067363

“Meeting Coverage 03.30.2015”

“MIXED RESULTS FOR AVASTIN PLUS CHEMO IN OVARIAN CANCER

Regimen improves survival but study misses cutoff for statistical significance… Patients who received carboplatin, paclitaxel, and bevacizumab had a median overall survival (OS) of 42.2 months compared with 37.3 months for platinum-taxane doublet. Nonetheless, the 5-month difference just missed the trial's cutoff for statistical significance (P=0.056 versus P=0.05)…

"Paclitaxel plus carboplatin and bevacizumab extended overall survival in patients with platinum-sensitive recurrent ovarian cancer, but the difference did not reach statistical significance," said Robert L. Coleman, MD, of the MD Anderson Cancer Center in Houston. "The combination was associated with a significant improvement in progression-free survival."

Adverse events occurred more frequently with bevacizumab, including grade 3-plus thromboembolism (4% versus 1%),

Infection (13% versus 6%),

Hypertension (12% versus 1%),

And proteinuria (8% versus 0%).

Gastrointestinal perforation, fistula, or abscess (all grades) also occurred more often in the bevacizumab arm (15% versus 4%).

In general, a quality-of-life assessment showed no deterioration of life quality in patients randomized to bevacizumab.

Adverse events of special interest occurred with similar frequency in the two arms: allergy/hypersensitivity reaction (27% with bevacizumab, 25% without),

all-cause mortality (2.4% versus 0.6%), and deaths possibly related to study treatment (2% overall)… The GOG213 trial was supported by the National Cancer Institute.”

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8.      http://www.medpagetoday.com/clinical-context/GynecologicCancers/56872

cme/ce Clinical Context 03.22.2016

“SGO: Optimal Chemo for Ovarian Cancer Fails to Emerge

No PFS difference among three regimens evaluated in key trial

• by Charles Bankhead - Staff Writer, MedPage Today

Action Points

• Note that these studies were published as abstracts and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
• Results of a long-awaited ovarian cancer trial failed to show an advantage for any of three chemotherapy regimens.
• Note that the regimens -- involving combinations of intraperitoneal (IP) and intravenous (IV) chemotherapy plus bevacizumab (Avastin) -- led to a median progression-free survival of 27 to 29 months in patients with optimally debulked stage II-III disease.

SAN DIEGO -- A roomful of gynecologic oncologists walked away disappointed after results of a long-awaited ovarian cancer trial failed to show an advantage for any of three chemotherapy regimens.

The regimens -- involving combinations of intraperitoneal (IP) and intravenous (IV) chemotherapy plus bevacizumab (Avastin) -- led to a median progression-free survival (PFS) of 27 to 29 months in patients with optimally debulked stage II-III disease.

An analysis limited to patients with optimal stage III disease yielded median PFS values of 31 to 34 months.

The results were a far cry from the 60-month median PFS in optimally debulked patients achieved with a higher dose of IP cisplatin in the Gynecologic Oncology Group (GOG) 172 trial reported more than a decade ago, and the three regimens' median PFS values remained similar to the 24-month median for all patients in GOG 172.

Moreover, toxicity remained a problem, although not nearly as severe as what was observed in GOG 172, reported Joan L. Walker, MD, of Oklahoma University's Stephenson Cancer Center in Oklahoma City, here at the Society of Gynecologic Oncology meeting…”

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