Evidence map›Paper›PMID 41084073›Full record

ArticleCardio-oncology (London, England)2025

Efficacy and cardiovascular safety of liposomal doxorubicin: a systematic review and meta-analysis of randomized trials.

Germano Dallegrave Cavalli, Jose P Lopez-Lopez, Frances Caringal Carandang, Ainsley Johnstone, Sara Scampoli, Ruqqiyah Rana, Pedro Teixeira Meireles, Jo-Anne Petropoulos, Christopher Hillis, Amaris Balitsky and 2 more

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Article in Cardio-oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Germano Dallegrave Cavalli *Department of Medicine, McMaster University, Hamilton, ON, Canada.
Jose P Lopez-Lopez *Department of Medicine, McMaster University, Hamilton, ON, Canada. josepatriciolopez@gmail.com.
Frances Caringal CarandangDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Ainsley JohnstoneDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Sara ScampoliDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Ruqqiyah RanaDepartment of Medicine, McMaster University, Hamilton, ON, Canada.
Pedro Teixeira MeirelesDepartment of Medicine, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil.
Jo-Anne PetropoulosHealth Sciences Library, McMaster University, Hamilton, ON, Canada.
Christopher HillisDepartment of Oncology, McMaster University, Hamilton, ON, Canada.
Amaris BalitskyDepartment of Oncology, McMaster University, Hamilton, ON, Canada.
Jenica UpshawDivision of Cardiology, Tufts Medical Center, Boston, MA, USA.
Darryl P LeongDepartment of Medicine, McMaster University, Hamilton, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAnthracyclines can cause dose-dependent cardiotoxicity that may be irreversible. To minimize cardiotoxic effects, substituting doxorubicin for liposomal doxorubicin (LD) has been explored as a cardioprotective strategy.

objectivesTo describe randomized clinical trials (RCTs) comparing the efficacy and safety of LD with other anthracycline-based regimens.

methodsWe conducted a systematic review and meta-analysis of RCTs comparing LD with other anthracycline-based regimens, using data from Medline, Embase, Emcare, the Cochrane Central Register, and LILACS.

resultsTwelve studies including 3027 patients with breast cancer (6), multiple myeloma (2), lymphoma (2), sarcoma (1), and acute lymphocytic leukemia (1) were included. Most participants (86%) were women with breast cancer. Nine studies compared LD with conventional doxorubicin and three with epirubicin. Overall, the risk of bias was classified as "some concerns". Follow-up ranged from 24-72 months - the median follow-up time among the studies was 37 months. There was a reduction in heart failure (HF) incidence in the LD group compared to the control (RR 0.32, 95%CI 0.18-0.55). A significant decrease in left ventricular ejection fraction (LVEF), as defined by each study´s criteria, was less frequent in the LD group compared to other anthracycline-based therapies (RR 0.39, 95%CI 0.30-0.51). All-cause mortality (RR 0.98, 95%CI 0.90-1.07) and tumor response (RR 0.99, 95%CI 0.93-1.05) did not differ between the groups.

conclusionsLD use was associated with a decrease in the occurrence of HF compared to other anthracycline-based therapies, with no worse cancer outcomes. A significant decrease in LVEF was also less frequent in the LD group; however, no difference was found in cardiovascular mortality.

Indexed as

CardioprotectionCardiotoxicityDoxorubicinHeart failureLiposomal doxorubicin

Identifiers

PMID41084073
PMCPMC12519849

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.