Doxorubicin Cancer Treatment

Doxorubicin
Two doxorubicin molecules
intercalating a strand of DNA.

Doxorubicin, a chemotherapeutic agent in wide use in anti-cancer treatment, is probably as effective as it is dangerous, thereby nicely representing the full pantheon of chemotherapy drugs in its dual and contradictory abilities to both cure and kill.

Drug profile

  • Class: Anthracycline antitumor antibiotic
  • Mechanism of action: It is a DNA intercalating agent, meaning it inserts itself in between base pairs of DNA and inhibits DNA repair.
  • Treatment type: Chemotherapy
  • US approval: 1974
  • Synonyms: Adriamycin, hydroxyl daunorubicin, Adria, Rubex
  • FDA Use-in-Pregnancy Rating: Category D

What Doxorubicin is effective for and why

Available only as in injection since it was first approved by the FDA, doxorubucin has applications in an incredibly broad range of cancers, including: lymphomas, adrenocortical cancer, bladder cancer, endometrial cancer, breast cancer, multiple myeloma, thymic carcinoma, vaginal cancer, osteosarcoma, soft tissue sarcomas, ovarian cancer, lung cancer, gastric cancer and cancers of unknown primary. It is a component of various combination chemotherapy regimins, including ABVD, R-CHOP, BEACOPP and Hyper-CVAD, to name a few.

Doxorubicin Side effects: Overview

Like other anthracyclines, doxorubicine's potential for cardiotoxicity and therefore damage to the heart is well known. The drug can also cause myelosuppression, fatigue, easy bruising or bleeding, infections, fever, chils, nausea, vomiting, loss of appetite, and the host of symptoms associated with an allergic reaction, such as hives or difficulty breathing.

Furthermore, doxorubicin is a powerful vesicant, or a substance known to cause human tissue to blister. Therefore it is important when being administered that precautions are undertaken by health professionals to prevent extravasation, which in this case refers to leakage of the drug from the veins into the surrounding tissue, where it can cause the tissue to die.

In addition to these issues, doxocubicin is generally contra-indicated in patients who have:

  • Liver disease
  • Heart disease
  • Kidney disease
  • Undergone radiotherapy the field of which included the heart
  • Received prior treatmeant with doxorubicin or any of its analogues

Sources

  • Boyiadzis, Michael M. et al. Hematology-Oncology Therapy. 2007. New York: McGraw Hill, Medical Publishing Division.
  • Guide to Cancer Drugs, American Cancer Society
  • Cancer Drug Manual, BC Cancer Agency
  • Perry, Michael C, Editor. Companion Handbook to the Chemotherapy Sourcebook. 1999. Baltimore; Williams & Wilkins.
  • Drugs.com: Doxorubicin

Significant studies relating to doxorubicin


 

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