Dexrazoxane Protects Breast Cancer Patients With Diabetes From Chemotherapy-Induced Cardiotoxicity

Sun, Fan; Li, Xingtao; Qi, Xiaoyong; Chen, Geng

doi:10.1097/maj.0000000000000432

Cited by 13 publications

(7 citation statements)

References 43 publications

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“…The highest mean baseline LVEF was 69.7% [31] and the lowest was 54.9% [21,37]. A total of 9 out of 26 studies had a baseline mean LVEF above 65.0% [18,19,22,27,30,31,33,38,40], 13 out of 26 studies were between 60.0% to 65.0% [15][16][17]20,[23][24][25][26]28,32,34,36,39], 2 out of 26 studies between 55.0% to 60.0% [29,35] and 2 out of 26 studies between 50.0% and 55.0% [21,37]. Anthracyclines administered to cancer patients included doxorubicin, epirubicin, idarubicin and daunorubicin.…”

Section: Results Of the Literature Searchmentioning

confidence: 99%

Natural Progression of Left Ventricular Function following Anthracyclines without Cardioprotective Therapy: A Systematic Review and Meta-Analysis

Lee

Yau

Low

et al. 2023

Cancers

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Background: Anthracyclines form the backbone of many systemic chemotherapy regimens but are accompanied by dose-limiting cardiotoxicity. We elucidate the progression and severity of cardiac function over time, in the absence of cardioprotection, which less is known about. Methods: This PRISMA-guideline-adherent review was registered on PROSPERO (CRD42022373496). Results: 26 studies met the eligibility criteria including a total of 910 patients. The overall reduction in post-anthracycline pooled mean left ventricular ejection fraction (LVEF) in placebo arms of the included randomised-controlled trials was 4.5% (95% CI, 2.6 to 6.4). The trend in LVEF showed a progressive decline until approximately 180 days, after which there was no significant change. Those receiving a cumulative anthracycline dose of 300 mg/m2 experienced a more profound reduction. The overall pooled risk of a 10% absolute decline in LVEF from baseline, or a decline to an LVEF below 50%, was 17% (95% CI: 11 to 24; I2 = 71%). Sensitivity analyses of baseline LVEF and trastuzumab treatment status did not yield significant differences. Conclusion: While the mean LVEF decline in patients without cardioprotective therapy was clinically small, a vulnerable subset experienced significant impairment. Further research to best identify those who benefit most from cardioprotective therapies when receiving anthracyclines is required.

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Section: Results Of the Literature Searchmentioning

confidence: 99%

Natural Progression of Left Ventricular Function following Anthracyclines without Cardioprotective Therapy: A Systematic Review and Meta-Analysis

Lee

Yau

Low

et al. 2023

Cancers

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“…[36,37] However, multiple studies have reported various side effects associated with dexrazoxane, including an increased risk of secondary malignancy and compromising antitumor effects of chemotherapy, which has limited its clinical use. [38][39][40] Astragalus polysaccharide has been used for years in traditional Chinese medicine to treat cardiovascular diseases including coronary heart disease and HF. Astragalus polysaccharide has been shown to improve heart function and ameliorate cardiovascular symptoms, such as palpitations, shortness of breath, and chest pain.…”

Section: Discussionmentioning

confidence: 99%

Preventing effect of astragalus polysaccharide on cardiotoxicity induced by chemotherapy of epirubicin: A pilot study

Guo

et al. 2022

Medicine

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To assess the clinical effect of astragalus polysaccharide in preventing cardiotoxicity induced by chemotherapy of epirubicin. Two hundred forty-eight patients with breast cancer or malignant lymphoma were randomly divided into the experimental group (EG) (n = 124) and the control group (CG) (n = 124). The EG received chemotherapy regimen containing anthracycline epirubicin and astragalus injection, while CG received only chemotherapy regimen containing anthracycline epirubicin. We detected myocardial function (cardiac troponin I [cTnI], creatine kinase isoenzyme [CK-MB], left ventricular ejection fraction [LVEF], and the ratio of mitral annular diastolic peak velocity to atrial systolic velocity [E/A]) and incidences of cardiotoxicity to assess cardiac function, they were compared at before the first treatment course (T 1 ), end of the second course (T 2 ) and 6-month follow-up. We also detected proinflammatory cytokines (IL-6 and TNF-α), reactive oxygen species and antioxidant enzymes, glutathione peroxidase (GPx), and superoxide dismutase (SOD) aimed to discover potential mechanism. There were no statistical significances in differences of LVEF and E/A between 2 groups ( P > .05) at T 1 and T 2 , while levels of LVEF and E/A of EG were significant higher than those of the CG at 6 month follow-up, with statistically significant differences ( P < .05). At T 1 , there were no statistical significances in differences of cTnI and CK-MB between 2 groups ( P > .05); at T 2 and 6 months follow-up, the cTnI, and CK-MB levels of EG was significantly lower than those of the CG, with statistically significant differences ( P < .05). The incidence of cardiotoxicity of EG was 15% (17/113), which was significant lower than that of the CG (60%, 66/110), with statistically significant difference ( P < .05). Moreover, the level of TNF-α, GPx, and SOD did not show significant difference ( P > .05). The data in this pilot study suggested that astragalus polysaccharide may be an effective therapy for preventing cardiotoxicity induced by chemotherapy of epirubicin. Furthermore, larger, placebocontrolled, perspective studies are needed to assess the efficacy of astragalus injection treatment for preventing cardiotoxicity induced by chemotherapy of epirubicin.

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“…We undertook several pre-planned subgroup analyses according to key trial, patient and treatment characteristics to identify risk factors and associations for a poorer prognosis. that involved cancer patients receiving over a mean cumulative anthracycline dose (CAD) of 300mg/mm2 for subgroup analysis as anthracyclines are established to cause cardiotoxicity in a dose-dependent manner [17,23,27,28,[30][31][32][33][34][35].…”

Section: Sensitivity and Subgroup Analysismentioning

confidence: 99%

Natural Progression of Left Ventricular Function Following Anthracyclines without Cardioprotective Therapy: A Systematic Review and Meta-Analysis

Lee¹,

Yau²,

Low³

et al. 2022

Preprint

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Background: Anthracyclines form the backbone of many systemic chemotherapy regimens but dose-limiting cardiotoxicity can also lead to reduction in cardiac function and an increased risk of heart failure. Methods: This review was conducted in accordance with PRISMA guidelines and registered on PROSPERO (CRD42022373496). Results: 26 studies met the eligibility criteria including a total of 910 patients. Overall reduction in pooled mean left ventricular ejection fraction (LVEF) post‐anthracyclines in the placebo arms of included randomised-controlled trials was 4.6% (95% CI, 2.7 to 6.6). The trend in LVEF showed a progressive decline until approximately 180 days after which there was no significant change. Those receiving a cumulative anthracycline dose 300 mg/m2 experienced a more profound reduction. The risk of a 10% absolute decline in LVEF from baseline or decline to an LVEF below 50%, the overall pooled risk was 16% (95% CI: 11 to 21; I2 = 77%). Sensitivity analyses by baseline LVEF and trastuzumab treatment status did not yield significant differences. Conclusion: While the mean LVEF decline in patients without cardioprotective therapy was clinically small, a vulnerable subset experienced significant impairment. Further research to best identify those who benefit most from cardioprotective therapies when receiving anthracyclines are required.

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Dexrazoxane Protects Breast Cancer Patients With Diabetes From Chemotherapy-Induced Cardiotoxicity

Cited by 13 publications

References 43 publications

Natural Progression of Left Ventricular Function following Anthracyclines without Cardioprotective Therapy: A Systematic Review and Meta-Analysis

Natural Progression of Left Ventricular Function following Anthracyclines without Cardioprotective Therapy: A Systematic Review and Meta-Analysis

Preventing effect of astragalus polysaccharide on cardiotoxicity induced by chemotherapy of epirubicin: A pilot study

Natural Progression of Left Ventricular Function Following Anthracyclines without Cardioprotective Therapy: A Systematic Review and Meta-Analysis

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