Key result
Liposomal doxorubicin and epirubicin plus dexrazoxane had superior cardioprotective effects compared to doxorubicin (OR 3.75; 95% CI 2.46-5.70 and OR 3.66; 95% CI 1.09-12.33, respectively).
Why the study?
The effects of anthracycline-based chemical therapies on breast cancer are controversial and inconclusive.
Do alternative anthracycline strategies (epirubicin, liposomal doxorubicin, or addition of dexrazoxane) reduce cardiotoxicity and maintain efficacy compared to doxorubicin in patients with breast cancer?
Population
3,484 patients with breast cancer across 19 randomized clinical trials
Comparison
Doxorubicin, epirubicin, liposomal doxorubicin, doxorubicin + dexrazoxane, and epirubicin + dexrazoxane
Design
Network meta-analysis of randomized clinical trials
Authors
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Supports liposomal doxorubicin or epirubicin-dexrazoxane over doxorubicin in breast cancer; confirms superior cardioprotection with preserved efficacy.
Meta-Analysis (n=3,484)
Do alternative anthracycline strategies (epirubicin, liposomal doxorubicin, or addition of dexrazoxane) reduce cardiotoxicity and maintain efficacy compared to doxorubicin in patients with breast cancer?
Odds Ratio: 3.75 (95% CI 2.46–5.7)
Liposomal doxorubicin or epirubicin plus dexrazoxane offer the most favorable balance of reduced cardiotoxicity and preserved efficacy in breast cancer patients compared to standard doxorubicin.
Mao et al. (2019) conducted a meta-analysis in breast cancer (n=3,484). Liposomal doxorubicin (LD) and epirubicin + dexrazoxane (ED) vs. Doxorubicin was evaluated on Cardioprotective effects (cardiotoxicity) (OR 3.75, 95% CI 2.46-5.70). Liposomal doxorubicin and epirubicin plus dexrazoxane had superior cardioprotective effects compared to doxorubicin (OR 3.75; 95% CI 2.46-5.70 and OR 3.66; 95% CI 1.09-12.33, respectively).
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