***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: PURPOSE A multicenter phase II study to determine the activity and toxicity of Caelyx ( Doxil ; Sequus Pharmaceuticals Inc , Menlo Park , CA ) in patients with metastatic breast cancer . PATIENTS AND METHODS Seventy-one patients with stage IV breast cancer were treated with Caelyx at doses of 45 to 60 mg/m2 every 3 to 4 weeks for a maximum of six cycles . Twenty-eight patients had received prior chemotherapy with a nonanthracycline regimen . Fifty-two patients had disease at multiple sites . Hepatic and pulmonary disease were the predominant metastatic site in 50 patients . Response was assessable in 64 cases . RESULTS Sixteen patients achieved a partial response and a complete response ( overall response rate , 31 % ; ( 95 % confidence interval , 20 % to 43 % ) . Twenty patients ( 31 % ) had stable disease on treatment . Neutropenia > or = grade 3 occurred in 10 % of cycles ( 27 % of patients ) and mucositis > or = grade 3 in 10 % of cycles ( 32 % of patients ) . Significant alopecia was rare and routine prophylactic antiemetics were not required . At doses of 60 mg/m2 every 3 weeks , seven of 13 patients had > or = grade 3 skin toxicity ; overall , this toxicity complicated 25 % of treatment cycles . The incidence of > or = grade 3 skin toxicity was greatly reduced at doses of 45 mg/m2 every 4 weeks , occurring in five of 32 patients and affecting only 5 % of 126 treatment cycles . CONCLUSION Caelyx is an active agent in advanced breast cancer with a safety profile that differs markedly from nonliposomal doxorubicin . A regimen of 45 mg/m2 every 4 weeks was well tolerated in this cohort of women with advanced poor-prognosis breast cancer . The mild myelosuppression seen with this regimen would favor its use in combination chemotherapy 
    Output:
    
We found that the most important side effects of PLD were skin toxicity and mucositis , but the proportion of patients who showed grade III and IV of these side effects was relatively low .
On the other h and , the occurrence of cardiotoxicity , the most important problem with doxorubicin , was considerably reduced in patients treated with PLD .
Although PLD has demonstrated a lower toxicity profile than conventional anthracyclines , it has also new side effects .
However , it seems that the reduced cardiotoxicity of PLD has made it a more appropriate option in patients with MBC , especially in those with risk factors for cardiac diseases