Other uses of dexrazoxane: savene, the first proven antidote against anthracycline extravasation injuries

Abstract

Dexrazoxane has been in clinical use for more than 25 years for prevention of cardiotoxicity in anthracycline based anticancer therapy. However, we discovered another property of the compound, i.e. the ability to prevent the devastating tissue necrosis after accidental extravasation of anthracyclines. The preclinical and clinical studies leading to the clinical implementation of Savene (dexrazoxane) as the first and only proven antidote in anthracycline extravasation are described in short.

Induction of thrombospondin-1 partially mediates the anti-angiogenic activity of dexrazoxane

“…At this dosage, it has not been associated with an increased incidence of secondary malignant neoplasms (Barry et al , 2008). It is also currently the only antidote for accidental anthracycline extravasation to prevent tissue necrosis (Langer et al , 2007). …”

The management of cytotoxic chemotherapy extravasation: a systematic review of the literature to evaluate the evidence underpinning contemporary practice

“…), and the UKNOS () alongside ‘expert opinion’ from authors such as Langer et al . (,b, , , , , ), Langer (, ,b), Schulmeister (, ,b,c,d, , ,b, ,b,c, ), Dougherty (, ), Dougherty and Lister (), Dougherty and Oakley (), Gault (), and Gault and Challands (). This would suggest that the management of extravasation continues to remain empirical and based on the expert views of lead opinion makers.…”

“…While 58% (n = 109) of the initial retrieved citations (n = 189) were level 5 evidence and therefore excluded from the final analysis, some have been used for discussion purposes (EONS, 2007;Schulmeister 2007d;Wengstrom & Marguiles 2008;Perez Fidalgo et al 2012;De Wit et al 2013). The rationale for this being that contemporary practice appears to be guided by publications from national and international societies: the Working Group of the German Cancer Society for Supportive Care in Oncology, Rehabilitation and Social Medicine -ASORS (De Wit et al 2013), the EONS (EONS 2007;Wengstrom & Marguiles 2008;Perez Fidalgo et al 2012), the European Society of Medical Oncology (Perez Fidalgo et al 2012), and the UKNOS (2008) alongside 'expert opinion' from authors such as Langer et al (2000aLanger et al ( ,b, 2001Langer et al ( , 2006Langer et al ( , 2007Langer et al ( , 2009Langer et al ( , 2012, Langer (2008Langer ( , 2010a, Schulmeister (2005, 2007a,b,c,d, 2008, 2009a,b, 2010a,b,c, 2011), Dougherty (2003, 2010, Dougherty and Lister (2008), Dougherty and Oakley (2011), Gault (1993), and Gault and Challands (1997). This would suggest that the management of extravasation continues to remain empirical and based on the expert views of lead opinion makers.…”

Cancer Therapy Using Antibiotics

“…Hence, the potential use of this strain for scale up of oligomycin is immense [42]. Dexrazoxane, which is a cardioprotective agent for use in conjunction with doxorubicin has shown the ability to prevent the devastating tissue necrosis after anthracyclines use and hence is the first and only proven antidote in anthracycline extravasation [43]. A lactam analog of Actinomycin D was newly synthesized as a potential antitumor chemotherapeutic agent.…”