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Abstract
Introduction: Soft tissue sarcomas (STS) comprise a group of uncommon mesenchymal tumors of heterogeneous differentiation. For advanced STS, single-agent doxorubicin or doxorubicin-based combinations are commonly used, but at serious risk of cumulative cardiotoxicity. In addition, doxorubicin is the sheet anchor drug for many malignancies, both solid and hematologic.
Areas covered: Aldoxorubicin, a doxorubicin prodrug currently in development, was designed to bind covalently to serum albumin and remains conjugated until transported to an acidic environment, such as the tumor site. We review the novel mechanism of action and the published pharmacokinetic, safety and efficacy data from Phase I, Ib/II and II clinical studies of aldoxorubicin in patients with advanced solid tumors, including advanced STS.
Expert opinion: Chemical modification of doxorubicin, an effective but cardiotoxic chemotherapy drug, to aldoxorubicin has yielded a notable improvement in patient outcomes. This small step in drug chemistry may provide a giant leap in the future of cancer treatment. With its improved efficacy and low incidence of acute cardiotoxicity, aldoxorubicin may supersede doxorubicin as the treatment of choice for STS and other malignancies.
Declaration of interest
SP Chawla has received research support from CytRx. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.