How can anthracycline-induced cardiotoxicity be prevented?

How can anthracycline-induced cardiotoxicity be prevented?

Dexrazoxane cardioprotection. Dexrazoxane is the only FDA- approved drug for preventing anthracycline-induced cardiotoxicity [46]. In August 2014, the FDA designated dexrazoxane as an orphan drug for “prevention of cardiomyopathy for children and adolescents 0 through 16 years of age treated with anthracyclines” [47].

Are anthracyclines cardiotoxic?

Unfortunately, anthracyclines are considered the principal culprit drugs behind chemotherapy-induced cardiotoxicity (1–5). The pathognomonic manifestation of anthracycline-induced cardiotoxicity is a hypokinetic cardiomyopathy progressively leading to heart failure, first described in 1967 (6).

Which patient receiving an anthracycline has the highest risk of cardiotoxicity?

Cumulative doses above 500 mg/m2 in adults and >300 mg/m2 in pediatric patients are associated with a higher risk of therapy-related cardiotoxicity [4, 5].

Can anthracyclines cause heart failure?

However, anthracyclines are associated with a risk of heart failure, with the risk proportionate to the cumulative exposure; cardiac injury appears to occur with every dose, and cardiac-biopsy specimens obtained within hours after a single dose of an anthracycline (e.g. doxorubicin or daunorubicin) show pathologic …

How can you prevent cardiotoxicity?

There are four main strategies to mitigate anthracycline-related cardiotoxicity; decreasing lifetime cumulative dose, prolonged intravenous infusion, liposomal formulation, and the addition of dexrazoxane.

Why are anthracyclines cardiotoxic?

Anthracycline-induced cardiotoxicity is due in large part to the generation of free radicals from doxorubicin through mitochondrial redox cycling of doxorubicin in the cardiomyocyte, which ultimately results in left ventricular dysfunction, and in the most severe cases, congestive heart failure.

How long after anthracycline therapy can late onset toxicity occur?

[10,11] Late-onset cardiotoxicity occurs more than 1 year after completion of anthracycline treatment. The late toxicity is a major concern in clinical scenarios where anthracyclines are used as part of a curative or adjuvant regimen-for example, in patients with breast cancer.

Do anthracyclines cause cardiomyopathy?

Anthracycline-induced cardiac dysfunction (ACD) is a notorious side effect of anticancer treatment. It has been described as a phenomenon of a continuous progressive decline of cardiac function, eventually leading to dilated cardiomyopathy (DCM).

Why do anthracyclines cause cardiotoxicity?

Can you reverse cardiotoxicity?

Can cardiotoxicity be reversed? Cardiotoxicity may be reversible. Research has shown that cardiotoxicity that arises after using trastuzumab may be reversible. Cardiotoxicity that arises from anthracycline use is often not reversible and requires long-term treatment.

What are anthracycline drugs?

Anthracyclines are widely used chemotherapy drugs derived from certain types of Streptomyces bacteria. Anthracycline drugs are used to treat many types of cancer, including leukemias, lymphomas, and cancers of the breast, stomach, uterus, ovary, and lung, among others.

Can cardiotoxicity be reversed?

What is a potential long-term side effect of anthracycline chemotherapy?

Anthracycline-containing chemotherapy causes long-term impairment of mitochondrial respiration and increased reactive oxygen species release in skeletal muscle – PMC. The .

What is an example of an anthracycline?

A type of antibiotic that comes from certain types of Streptomyces bacteria. Anthracyclines are used to treat many types of cancer. Anthracyclines damage the DNA in cancer cells, causing them to die. Daunorubicin, doxorubicin, and epirubicin are anthracyclines.

How long after completion of anthracycline therapy can late onset toxicity occur?

Which medications are anthracyclines?

Anthracycline chemotherapy medicines are:

  • Adriamycin (chemical name: doxorubicin)
  • Ellence (chemical name: epirubicin)
  • Doxil (chemical name: doxorubicin)
  • daunorubicin (brand names: Cerubidine, DaunoXome)
  • mitoxantrone (brand name: Novantrone)