ArticleBreast cancer (Dove Medical Press)2026
Association of Pegylated Liposomal Doxorubicin with Improved Overall Survival Compared with Epirubicin in Early-Stage Breast Cancer: A Population Based Study from Taiwan.
Article in Breast cancer (Dove Medical Press), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Anthracycline-based regimens are a cornerstone of adjuvant therapy for early-stage breast cancer but are limited by cumulative cardiotoxicity. This study compared the effectiveness and cardiotoxicity of pegylated liposomal doxorubicin (Lipo-Dox) and epirubicin in women with early-stage, HER2-negative breast cancer using nationwide real-world data from Taiwan. Patients and Methods: This population-based retrospective cohort study used Taiwan's National Health Insurance Research Database to identify adult women with stage I-III, HER2-negative breast cancer treated with adjuvant anthracycline-based chemotherapy between 2006 and 2018. Propensity score matching (1:1) was performed to balance baseline characteristics, resulting in 1050 matched patients with a median follow-up of 6.05 years. Overall survival (OS), disease-free survival (DFS), and cardiotoxicity were analyzed using Cox proportional hazards models and Kaplan-Meier methods. Results: Compared with epirubicin, Lipo-Dox was associated with significantly improved overall survival (adjusted hazard ratio 0.754, 95% CI 0.632-0.899; P < 0.001). Survival benefits were consistent across 3-year, 5-year, and full follow-up analyses and demonstrated a dose-dependent relationship. Kaplan-Meier curves confirmed superior overall survival in the Lipo-Dox group (log-rank P < 0.001). No significant differences were observed between the two groups in disease-free survival or clinically diagnosed cardiac events. Conclusion: In this nationwide propensity score-matched cohort, adjuvant Lipo-Dox was associated with sustained overall survival benefits without increased cardiotoxic risk compared with epirubicin. Lipo-Dox may represent a favorable anthracycline alternative, particularly for patients with cardiovascular comorbidities or elevated cardiotoxicity risk.
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