Pixantrone dimaleate for treating non-Hodgkin’s lymphoma

Introduction: The management options for relapsed/refractory non-Hodgkin’s lymphoma (NHL) are limited in terms of effectiveness and toxicity. Anthracyclines are important in a range of solid tumours but cardiotoxicity can limit their role. We describe the development of pixantrone dimaleate, an agent intended to retain efficacy and reduce the risk of cardiotoxicity when compared to anthracyclines.Areas covered: The role of anthracyclines in solid tumours and the associated cardiotoxicity was reviewed specifically looking at paediatric and elderly patients, patients with breast cancer and patients with co-existent cardiac comorbidities. A systematic literature review of all trials in NHL using pixantrone dimaleate was carried out. We summarise all the existing trials. The clinical use of the agent and the product characteristics are described.Expert opinion: The regulatory approval for this drug from the European Medicines Agency and clinical use as per National Institute of Health and Clinical Excellence is highlighted. We describe its scope for transforming the management of NHL, and its role in other solid tumours where anthracyclines are required. In particular, its potential as a useful drug for paediatric patients where long-term toxicity is an issue and patients who have previously had anthracyclines or have pre-existing comorbidities, which would preclude anthracyclines are discussed.