Dexrazoxane cardioprotection in advanced breast cancer patients undergoing high-dose epirubicin treatment

P. Vici, A. Ferraironi, L. Di Lauro, S. Carpano, F. Conti, F. Belli, G. Paoletti, C. L. Maini, M. Lopez

Research output: Contribution to journalArticle

Abstract

Purpose: We performed a randomized trial to evaluate the cardioprotective effect of dexrazoxane (DEX) in advanced breast cancer patients (ABC) treated with high single-dose epirubicin (EPI). A secondary objective was to determine the role of radio-immunoscintigraphy (RIS) in the assessment of epirubicin cardiotoxicity. Patients and Methods: Ninety-five patients with ABC were treated with EPI 160 mg/m2 by iv bolus every 3 weeks with or without DEX, 1,000 mg/m2 iv. Cardiac monitoring included multigated radionuclide (MUGA) scan with determination of resting left ventricular ejection fraction (LVEF), and RIS with 111-Indium antimyosin monoclonal antibodies. Results: The overall response rate was 69% in the EPI arm and 67% in the EPI+DEX arm; median time to response and median time to progression were identical in both arms, being 2 and 8 months, respectively. Median survival was 19 months versus 29 months (p 0.21), respectively. DEX did not appear to contribute to extracardiac EPI toxicity. Congestive heart failure occurred only in the EPI arm (2 instances). LVEF significantly decreased from baseline only in the EPI group. An abnormal tracer uptake at RIS was observed early in both arms, but the increase in heart to lung ratio was much more evident in the control group. Conclusions: DEX significantly protects against the development of high dose epirubicin cardiotoxicity apparently without evidence of an adverse impact on antitumor activity and non cardiac toxicity. RIS is a very sensitive technique in detecting anthracycline cardiac damage, but its specificity is low and cannot be considered alone a primary test for guiding anthracycline treatment.

Original languageEnglish
Pages (from-to)15-20
Number of pages6
JournalClinica Terapeutica
Volume149
Issue number1
Publication statusPublished - Jan 1998

Keywords

  • Advanced breast cancer
  • Dexrazoxane
  • High-dose epirubicin

ASJC Scopus subject areas

  • Medicine(all)

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    Vici, P., Ferraironi, A., Di Lauro, L., Carpano, S., Conti, F., Belli, F., Paoletti, G., Maini, C. L., & Lopez, M. (1998). Dexrazoxane cardioprotection in advanced breast cancer patients undergoing high-dose epirubicin treatment. Clinica Terapeutica, 149(1), 15-20.