Anthracyclines: Molecular Advances and Pharmacologic Developments in Antitumor Activity and Cardiotoxicity

@article{Minotti2004AnthracyclinesMA,
  title={Anthracyclines: Molecular Advances and Pharmacologic Developments in Antitumor Activity and Cardiotoxicity},
  author={Giorgio Minotti and Pierantonio Menna and Emanuela Salvatorelli and Gaetano Cairo and Luca Gianni},
  journal={Pharmacological Reviews},
  year={2004},
  volume={56},
  pages={185 - 229}
}
The clinical use of anthracyclines like doxorubicin and daunorubicin can be viewed as a sort of double-edged sword. On the one hand, anthracyclines play an undisputed key role in the treatment of many neoplastic diseases; on the other hand, chronic administration of anthracyclines induces cardiomyopathy and congestive heart failure usually refractory to common medications. Second-generation analogs like epirubicin or idarubicin exhibit improvements in their therapeutic index, but the risk of… 

Role of anthracyclines in the era of targeted therapy

In the current target therapy era in oncology, anthracyclines increase the antitumor effects in more than additive fashion, being excellent partners for other active agents like taxanes and trastuzumab.

New developments in anthracycline-induced cardiotoxicity.

This review discusses recent developments in the molecular mechanisms underlying anthracycline-induced cardiotoxicity, focusing on controversial aspects and on recent data regarding analogues of the natural compounds, tumor-targeted formulations and cardioprotective agents.

Research progress of cardioprotective agents for prevention of anthracycline cardiotoxicity.

By literature review, the research progress of cardioprotective agents for prevention of anthracycline cardiotoxicity is reviewed and hematopoietic stimulating factors are used to control the myelotoxicity.

Anthracycline-induced cardiac toxicity: A clinical review

A comprehensive account on the ATC is presented and up to date data on their clinical use and toxicity profile are provided and a contemporary approach on the early detection, diagnosis, and treatment of ATC CTX is provided.

Complications of chemotherapy, a basic science update.

Anthracyclines and mitochondria.

The potential role of mitochondria in the molecular mechanisms underlying anthracycline anticancer activity as well as in the pathogenesis of anthrACYcline-induced cardiotoxicity is reviewed.
...

References

SHOWING 1-10 OF 389 REFERENCES

Cardiac toxicity of antineoplastic anthracyclines.

No major improvement in therapeutic index has been obtained in anthracyclines synthesized and screened, but a possible exception might be represented by the new disaccharidic derivatives, which have provided promising results in preclinical studies.

The anthracyclines: will we ever find a better doxorubicin?

  • R. Weiss
  • Biology, Chemistry
    Seminars in oncology
  • 1992
Current studies are evaluating increased doses of epirubicin to improve anthracycline cytotoxicity, while limiting cardiotoxicity, but at present DOX still reigns in this drug class as the one having the most proven cancerocidal effect.

Anthracycline drug targeting: cytoplasmic versus nuclear--a fork in the road.

This review will present recent strategies in anthracycline design and assess their potential therapeutic merits, including cytoplasmic or nuclear sites.

Recent developments in the field of antitumour anthracyclines.

  • C. Monneret
  • Biology, Chemistry
    European journal of medicinal chemistry
  • 2001

Role of iron in anthracycline cardiotoxicity: new tunes for an old song?

  • G. MinottiG. CairoE. Monti
  • Biology
    FASEB journal : official publication of the Federation of American Societies for Experimental Biology
  • 1999
The present review applies a multisided approach to the critical evaluation of various hypotheses proposed over the last decade for the role of iron in anthracycline‐induced cardiotoxicity to build a unifying pattern that would both account for hitherto unexplained experimental observations and help design novel and more rational strategies toward a much‐needed improvement in the therapeutic index of anthRacyclines.

Doxorubicin cardiotoxicity: analysis of prevailing hypotheses

  • R. OlsonP. Mushlin
  • Biology
    FASEB journal : official publication of the Federation of American Societies for Experimental Biology
  • 1990
The hypotheses presented in this paper should provide a useful framework for subsequent investigations into the mechanisms of anthracycline cardiotoxicity, and are required to determine whether metabolites or the other putative injurious agents discussed contribute substantially to the cardiomyopathy of AnthracyCline therapy.

Role of apoptosis and apoptosis-related genes in cellular response and antitumor efficacy of anthracyclines.

The evidence that a novel disaccharide analog, endowed with an improved preclinical activity over doxorubicin, was also more effective as an inducer of apoptosis provided additional insights to better understand the cellular processes that confer sensitivity to anthracyclines.

Pharmacokinetic-Pharmacodynamic Relationships of the Anthracycline Anticancer Drugs

Data indicate that bolus administration, rather than continuous infusion, appears to be an important risk factor for anthracycline-induced cardiomyopathy, thus implying that this type of toxicity is maximum concentration-dependent.

Anthracyclines: selected new developments.

This review will focus on areas of the anthracycline field including synthesis of new analogues, new strategies of synthesis and recent developments in the area of drug delivery.
...