Introduction

Abstract 

Since their introduction in the 1960s, anthracyclines such as doxorubicin have attained a central place in the management of a number of solid tumours and haematological malignancies. Anthracycline-based regimens constitute a standard of care in patients with metastatic breast cancer; anthracycline monotherapy compares favourably with taxanes alone, while combinations of anthracyclines and taxanes have been shown to be superior to anthracycline-based regimens in terms of response rates and progression-free survival. Similarly, in patients with early breast cancer, adjuvant therapy with anthracycline-based regimens significantly reduces breast cancer mortality, compared with cyclophosphamide-methotrexate-fluorouracil regimens. However, a major limitation to the use of anthracyclines is cumulative cardiotoxicity, which can result in irreversible congestive heart failure. A number of strategies to reduce cardiotoxicity have been investigated, including modification of the dosing regimen, use of cardioprotective agents, and the development of liposomal doxorubicin formulations. The central place of anthracyclines in breast cancer management is likely to continue: the challenge now is to identify those patients most likely to respond to, and benefit from, anthracyclinebased therapy.

Keywords:  Anthracyclines , Breast cancer , Doxorubicin , Drug toxicity , Liposomal doxorubicin

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