CoChat
Sign Up
Cited by 223Chemotherapy-induced cardiotoxicity and mitigationCancer therapeutics and mechanismsCancer Treatment and Pharmacology

Epirubicin: A Review of its Pharmacodynamic and Pharmacokinetic Properties, and Therapeutic Use in Cancer Chemotherapy

Plosker, Greg L., Faulds, Diana·1993·Drugs
DOI 10.2165/00003495-199345050-00011
Open this paper in CoChat — free account

Abstract

Epirubicin is the 4' epimer of the anthracycline antibiotic doxorubicin, and has been used alone or in combination with other cytotoxic agents in the treatment of a variety of malignancies. Comparative and noncomparative clinical trials have demonstrated that regimens containing conventional doses of epirubicin achieved equivalent objective response rates and overall median survival as similar doxorubicin-containing regimens in the treatment of advanced and early breast cancer, non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), non-Hodgkin's lymphoma, ovarian cancer, gastric cancer and nonresectable primary hepatocellular carcinoma. Recently, dose-intensive regimens of epirubicin have achieved high response rates in a number of malignancies including early and advanced breast cancer and lung cancer. The major acute dose-limiting toxicity of anthracyclines is myelosuppression. In vitro and clinical studies have shown that, at equimolar doses, epirubicin is less myelotoxic than doxorubicin. The lower haematological toxicity of epirubicin, as well as the recent introduction of supportive measures such as colony-stimulating factors, has allowed dose-intensification of epirubicin-containing regimens, which is particularly significant because of the definite dose-response relationship of anthracyclines. Cardiotoxicity, which is manifested clinically as irreversible congestive heart failure and/or cardiomyopathy, is the most important chronic cumulative dose-limiting toxicity of anthracyclines. Epirubicin has a lower propensity to produce cardiotoxic effects than doxorubicin, and its recommended maximum cumulative dose is almost double that of doxorubicin, thus allowing for more treatment cycles and/or higher doses of epirubicin. In summary, dose-intensive epirubicin-containing regimens, which are feasible due to its lower myelosuppression and cardiotoxicity, have produced high response rates in early breast cancer, a potentially curable malignancy, as well as advanced breast, and lung cancers. Furthermore, there is evidence to suggest that improved response rates can improve quality of life in some clinical settings, but whether this leads to prolonged survival has not yet been determined. Recently implemented supportive measures such as colony-stimulating factors, prophylactic antimicrobials and peripheral blood stem cell support may help achieve other potential advantages of dose-intensive epirubicin-containing regimens such as reductions in morbidity and length of hospital admissions.

Integrity signals

Registry

Crossref · 10.2165/00003495-199345050-00011

Cites

426 of 426 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

3 of the 429 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Plosker, G. L., & Faulds, D.
Venue
Drugs
Publisher
Springer Science and Business Media LLC
Published
1993-05
Volume
45
Issue
5
Pages
788-856
ISSN
0012-6667 (ISSN-L)
DOI
10.2165/00003495-199345050-00011
OpenAlex
W1993672158
Cited by
223
References
429
Citations by year
2026: 6 · 2025: 9 · 2024: 13 · 2023: 8 · 2022: 14 · 2021: 10 · 2020: 5 · 2019: 4 · 2018: 1 · 2017: 10 · 2016: 7 · 2015: 5 · 2014: 7 · 2013: 10 · 2012: 4
FWCI
3.62
Type
journal article
Language
en
Open access
closed
Locations
  • Drugs (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Chemotherapy-induced cardiotoxicity and mitigation
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cancer therapeutics and mechanisms
  • Health Sciences › Medicine › Oncology › Cancer Treatment and Pharmacology
Keywords
epirubicin, anthracyclines, doxorubicin, dose-intensive chemotherapy, myelosuppression, cardiotoxicity, breast cancer, non-small cell lung cancer, small cell lung cancer, non-Hodgkin lymphoma, ovarian cancer, gastric cancer, hepatocellular carcinoma, colony-stimulating factors, hematopoietic growth factors
MeSH terms
Clinical Trials as Topic, Female, Humans, Male, Neoplasms, Epirubicin

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review