Anthracyclines adverse effects

Ixabepilone, a microtubule stabilizing agent, is indicated as monotherapy or in combination with capecitabine in MBC patients who have previously received an anthracycline and a taxane. Response rates and time to progression were increased with combination therapy as compared with capecitabine alone. Adverse effects include myelosuppression, peripheral neuropathy, and myalgias/arthralgias. 

Mucositis and stomatitis are potentially severe and dose-hmiting adverse effects of the anthracyclines. Both the frequency and the severity are dose-dependent (56,69). Their onset and recovery generaUy parallel the hematological toxicity, but they can occur earlier (5-10 days after treatment starts). Areas of painful erosions, mainly along the side of the tongue and on the subhngual mucosa, are common. Mucositis occurs in about 9% of patients who receive oral idambicin in standard doses (27). 

An interaction of doxorubicin with the anti-HER2 receptor humanized monoclonal antibody, trastuzumab (Herceptin), has been reported. Most patients who received trastuzumab in early trials had been pretreated with anthracyclines. Despite this, preliminary information suggested that reduced systolic cardiac function was an adverse effect of trastuzumab (119). More recently, this problem has been further highlighted in a study of women with metastatic breast cancer (120). Patients who had not received prior anthracycline-containing adjuvant chemotherapy were at greater risk of cardiotoxicity when they received trastuzumab in combination with doxorubicin or cyclophosphamide (27 and 75% respectively), compared with only 11% of patients who received trastuzumab in combination with pachtaxel (120,121). The risk of cardiac events in patients treated with doxorubicin, cyclophosphamide, and trastuzumab increased markedly after a cumulative doxorubicin dose of 360 mg/m. This suggests synergistic cardiotoxicity with trastuzumab and doxorubicin. Trastuzumab is therefore currently licensed only for use in conjunction with pacli-taxel or docetaxel and not with conventional doxorubicin. 

Cancer chemotherapy often delivers adverse effects to patients, such as bone marrow depression, loss of hair, or digestive organs disorder. Among the drugs, anthracyclines such as doxorubicin and epirubicin often pose the threat of... 

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