Medication to prevent anthracycline cardiotoxicity – Cardiology MCQ – Answer
Medication which is universally recommended to prevent anthracycline cardiotoxicity when high dose cancer chemotherapy is planned: Correct answer: 2. Dexrazoxane
Dexrazoxane has been used intravenously to protect the heart against chemotherapeutic agents like doxorubicin. US Food and Drug Administration has approved its use only in adult patients as there was a possible risk of secondary malignancy in pediatric patients. It is a derivative of EDTA and chelates iron so that less number is available to bind with anthracyclines and form superoxide radicals. Concerns have also been raised about its potential interference with antitumor effects of doxorubicin. A recent retrospective cohort study compared the 7 year follow up of those who had received dexrazoxane and a 7.5 year follow up of those who had not received it . Those who received the drug were older and were more likely to receive higher dose of anthracycline chemotherapy and adjuvant trastuzumab treatment. Dexrazoxane treatment was associated with a higher rates leukopenia, neutropenia, anemia and thrombocytopenia. Interestingly, cardiac events were similar in both groups and there was a non significantly lower morality in dexrazoxane group in spite of them being older.
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- Tahover E, Segal A, Isacson R, Rosengarten O, Grenader T, Gips M, Cherny N, Heching NI, Mesika L, Catane R, Gabizon A. Dexrazoxane added to doxorubicin-based adjuvant chemotherapy of breast cancer: a retrospective cohort study with a comparative analysis of toxicity and survival. Anticancer Drugs. 2017 Aug;28(7):787-794.