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Evidence summaries

Different Anthracycline Derivates for Reducing Cardiotoxicity in Cancer Patients

Liposomal-encapsulated doxorubicin appears to be less cardiotoxic than conventional doxorubicin Level of evidence: "B"

A Cochrane review [Abstract] 1 included 8 studies with a total of 1717 subjects. In all but one study the patients had a breast cancer.

Patients treated with liposomal-encapsulated doxorubicin compared with conventional doxorubicin had a lower rate of clinical heart failure (RR 0.20, 95% CI 0.05 to 0.75, 2 RCTs, 521 patients) and combined clinical and subclinical heart failure (RR = 0.38, 95% CI 0.24 to 0.59). There was no difference in the occurrence of clinical heart failure between doxorubicin and epirubicin treatment groups (RR = 0.36, 95% CI 0.12 to 1.11, 5 RCTs, 1036 patients), and in the occurrence of combined clinical and subclinical heart failure between epirubicin and liposomal-encapsulated doxorubicin treated groups (RR = 1.13, 95% CI 0.46 to 2.77).

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison). There are no data for children and patients with leukaemia.

    References

    • van Dalen EC, Michiels EM, Caron HN, Kremer LC. Different anthracycline derivates for reducing cardiotoxicity in cancer patients. Cochrane Database Syst Rev 2010;(5):CD005006 [Review content assessed as up-to-date: 26 November 2009]. [PubMed].

Primary/Secondary Keywords