[Dexrazoxane. Current status and prospectives of cardiotoxicity of chemotherapy].
OBJECTIVE
To evaluate efficacy of dexrazoxane (Cardioxane) in amelioration of chemotherapy induced cardiotoxicity.


METHODS
The most important experimental and clinical studies have been reviewed.


RESULTS
Dexrazoxane has been shown to reduce anthracycline-induced cardiotoxicity. The drug is thought to reduce cardiac toxicity by binding to free and bound iron, thus reducing the formation of anthracycline-iron complexes and the generation of free radicals which are toxic to cardiac tissue. The majority of clinical studies has been performed in patients with metastatic breast cancer. It has been shown that dexrazoxane: 1) significantly reduces the overall incidence of cardiac events, irrespective of pre-existing cardiac risk factors; 2) does not seem to affect anthracycline activity; 3) does not increase the incidence of chemotherapy induced non-cardiac toxic effects; 4) reduces cardiac toxicity in pediatric patients given anthracyclines; 5) is cost-effective.


CONCLUSIONS
Dexrazoxane is a valuable drug in amelioration of chemotherapy induced cardiotoxicity, both in adult and pediatric patients. Wether it offers protection against late-onset cardiac toxicity in this latter group of patients, remains to be demonstrated. Dexrazoxane should be always used, preferably from the onset of chemotherapy, when it is believed that cumulative doses of doxorubicin > or = 300 mg/m2 or of epirubicin > or = 480 mg/m2 will be reached.
Lopez
M
M
Istituto Regina Elena per lo Studio e la Cura dei Tumori, Roma, Italia.
D000328:Adult; D018943:Anthracyclines / Q000008:administration & dosage / Q000494:pharmacology; D002648:Child; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control*; D005260:Female; D006321:Heart / Q000187:drug effects*; D006331:Heart Diseases / Q000139:chemically induced* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D011929:Razoxane / Q000008:administration & dosage* / Q000494:pharmacology; D012307:Risk Factors
D018943:Anthracyclines; D011929:Razoxane
Dexrazoxane. Attualità e prospettive nella protezione dalla cardiotossicità indotta da chemioterapia.