Dexrazoxane : a review of its use for cardioprotection during anthracycline chemotherapy

Drugs. 2005;65(7):1005-24. doi: 10.2165/00003495-200565070-00008.


Dexrazoxane (Cardioxane, Zinecard, a cyclic derivative of edetic acid, is a site-specific cardioprotective agent that effectively protects against anthracycline-induced cardiac toxicity. Dexrazoxane is approved in the US and some European countries for cardioprotection in women with advanced and/or metastatic breast cancer receiving doxorubicin; in other countries dexrazoxane is approved for use in a wider range of patients with advanced cancer receiving anthracyclines. As shown in clinical trials, intravenous dexrazoxane significantly reduces the incidence of anthracycline-induced congestive heart failure (CHF) and adverse cardiac events in women with advanced breast cancer or adults with soft tissue sarcomas or small-cell lung cancer, regardless of whether the drug is given before the first dose of anthracycline or the administration is delayed until cumulative doxorubicin dose is > or =300 mg/m2. The drug also appears to offer cardioprotection irrespective of pre-existing cardiac risk factors. Importantly, the antitumour efficacy of anthracyclines is unlikely to be altered by dexrazoxane use, although the drug has not been shown to improve progression-free and overall patient survival. At present, the cardioprotective efficacy of dexrazoxane in patients with childhood malignancies is supported by limited data. The drug is generally well tolerated and has a tolerability profile similar to that of placebo in cancer patients undergoing anthracycline-based chemotherapy, with the exception of a higher incidence of severe leukopenia (78% vs 68%; p < 0.01). Dexrazoxane is the only cardioprotective agent with proven efficacy in cancer patients receiving anthracycline chemotherapy and is a valuable option for the prevention of cardiotoxicity in this patient population.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Anthracyclines / adverse effects*
  • Anthracyclines / therapeutic use
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Cardiovascular Agents / administration & dosage
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / economics
  • Cardiovascular Agents / pharmacokinetics
  • Cardiovascular Agents / therapeutic use*
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / prevention & control*
  • Humans
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Randomized Controlled Trials as Topic
  • Razoxane / administration & dosage
  • Razoxane / adverse effects
  • Razoxane / economics
  • Razoxane / pharmacokinetics
  • Razoxane / therapeutic use*


  • Anthracyclines
  • Antineoplastic Agents
  • Cardiovascular Agents
  • Razoxane