In a nutshell
This study investigated the effectiveness and side effects on the heart of anthracycline-based therapies (ABTs) for breast cancer. They found that non-doxorubicin (non-DXR) ABTs had a better benefit/risk ratio (BRR) than DXR alone.
Some background
Anthracycline-based therapies (ABTs) are commonly used to treat breast cancer (BC). ABTs are antibiotic drugs. They block enzymes that are involved in cell growth. This stops cancer cells from growing rapidly. There are many ABTs. These include dexrazoxane (Zinecard; DXZ), doxorubicin (Adriamycin; DXR), liposomal DXR (Caelyx; LD) and epirubicin (Ellence; ERB). These drugs are prescribed alone or in combination.
ABTs are also associated with side effects. One of these involves the heart. This is called cardiotoxicity (CTX). It is unclear how ABTs can cause heart damage. Despite this, ABTs are still used as they are very effective in treating BC. Some studies suggest that certain ABT combinations may be safer than others. It Is unclear if the effectiveness of ABTs can be achieved with low CTX in patients with BC.
Methods & findings
This study analyzed 19 clinical trials. This included data from 3,484 patients treated with ABTs. The authors compared data in these trials. The effectiveness of ABT drugs was compared. The risk of CTX was also compared across ABTs. The benefit/risk ratio (BRR) was calculated. A positive ratio means that the benefits outweigh the risks (side effects). BRR was compared to DXR monotherapy (single drug).
The BRR was positive for DXZ in combination with DXR or EBR. The BRR was also positive for LD compared to DXR. This means the effectiveness of these ABTs is greater than the risk of CTX.
The bottom line
The authors concluded that non-DXR ABTs had a better BRR than DXR alone in patients with BC.
The fine print
The treatment regimens varied in the clinical trials. Some information on CTX was not available. More investigation is needed.
What’s next?
If you have any concerns regarding BC treatment and its complications, please consult with your oncologist.
Published By :
Oncology research and treatment
Date :
May 17, 2019
