HHE Sponsored handbook: Cardioprotection in clinical | Page 4

4 HHE 2019
FIGURE 1B
Dexrazoxane protects against FAC-induced cardiac failure
in advanced breast cancer 1
1.0
Dexrazoxane
0.8
HR for Cardiac failure: 13.05
95% Cl: 3.72-46.0
p<0.001
0.6
0.4
Placebo
0.2
0.0
Dexrazoxane 102
Placebo
99
92
92
300
59
57
500
42
19
31
7
20
6
700
11
1
900
7
1
7
1
1100
3
1
2
1
2
1
1300
1
1
1500
Cumulative dose of doxorubicin mg/m 2
Cardioprotection in patients with advanced
and/or metastatic breast cancer
Cardioxane ® protects against anthracycline-
induced cardiotoxicity in patients with advanced
breast cancer. 1,15,16 Cardioxane ® preserves left
ventricular ejection fraction (LVEF) in patients
with advanced breast cancer treated with
doxorubicin-based chemotherapy. 15
Cardioxane ® treatment enables patients
to receive more cycles of doxorubicin-containing
chemotherapy and higher cumulative doses
of doxorubicin compared with patients
receiving chemotherapy alone. 15
The risk of cardiac events and risk of
heart failure following doxorubicin-based
chemotherapy in patients with advanced
breast cancer treated with fluorouracil,
doxorubicin, and cyclophosphamide are
significantly reduced by Cardioxane ®
compared with placebo (p<0.001). 1
(See Figures 1A and B).
Cardioxane ® administration protected
against epirubicin-associated reductions in
LVEF, and increases in brain natriuretic peptide
and cardiac troponin in patients receiving
adjuvant chemotherapy (Table 1). 2
TABLE 1
Cardioprotective effects of dexrazoxane in patients receiving epirubicin
for treatment of advanced breast cancer 2
Parameter n (%) Epirubicin alone (n=61) Before treatment After treatment P-value
BNP (pg/ml) 107 ± 4.5 187 ± 8.7 <0.05
cTNT (ng/ml) 12.6 ± 2.7 31.1 ± 7.1 <0.05
HR (bpm) 75.3 ± 7.1 89.6 ± 9.2 <0.05
LVEF 65.2 ± 7.8 55.2 ± 7.2 <0.05
Neutrophil count (x10 9 /l) 4.0 ± 1.4 3.5 ± 1.5 NS
Study design: 122 breast cancer patients were randomised to dexrazoxane (n=61) or contral (n=61) in addition to
an epirubicin-based adjuvant cemotherapy regimen. Dexrazoxane was administered at a ratio of 10:1 to epirubicin.
All patients received four cycles of adjuvant chemotherapy and changes in speciific cardiac functional status and
haematology status before and after chemotherapy, as well as non-cardiac toxicity, were observed and analysed.