Treatment including anthracyclines versus treatment not including anthracyclines for childhood cancer

Abstract

At the moment no evidence from RCTs is available which underscores the use of anthracyclines in ALL. However, 'no evidence of effect', as identified in this review, is not the same as 'evidence of no effect'. For Wilms' tumour, rhabdomyosarcoma and undifferentiated sarcoma, Ewing's sarcoma, non-Hodgkin lymphoma, hepatoblastoma and AML only one RCT was available for each type and, therefore, no definitive conclusions can be made about the antitumour efficacy of treatment with or without anthracyclines in these tumours. For other childhood cancers no RCTs were identified and therefore no conclusions can be made about the antitumour efficacy of treatment with or without anthracyclines in these tumours.

Dexrazoxane shows cytoprotective effects in zoledronic acid-treated human cells in vitro and in the rabbit tibia model in vivo

“…The side effect profile of the drug is favourable and concerns of secondary malignancy were not proved in trials (Barry et al, 2008;van Dalen et al, 2011;Tebbi et al, 2007). Reduced efficiency of chemotherapy has not been shown ( van Dalen et al, 2009). The drug dexrazoxane is available as Cardioxane (Novartis AG, Basel, CH).…”

Effect of Remote Ischaemic Conditioning in Oncology Patients Undergoing Chemotherapy: Rationale and Design of the ERIC‐ONC Study—A Single‐Center, Blinded, Randomized Controlled Trial

“…Pharmacological treatments to reduce myocyte damage during chemotherapy include antioxidants, iron chelation, and standard heart failure medications. Antioxidant strategies have proved disappointing; therapies such as L‐carnitine, co‐enzyme Q10, N‐acetylcysteine, and phenethylamines have proved disappointing in children and equivocal in adults, possibly because antioxidants exert their effect after free radical formation. Renin‐angiotensin‐system inhibition, statin therapy, and β‐blockers have shown promise in adult cardioprotection, but their universal adoption is constrained by interactions with renal function, transaminitis/myositis, and hemodynamic side effects, respectively.…”

Preoperative Chemotherapy With Doxorubicin in Wilms Tumor

“…Moreover, with regard to the clinical cardiotoxicity evaluated in 3 randomized controlled studies, no significant difference was found between the treatment arms including anthracyclines and not including anthracyclines for cancers in the pediatric age group. 8 Actinomycin-D is one of the drugs considered responsible for the development of hepatic venooclusive disease. 9 In a series of 206 patients with WT, the incidence of venooclusive disease was reported to be 5%.…”