The DOI matches its Crossref record; 426 of the 429 references it cites were found in a registry or an index.
Epirubicin: A Review of its Pharmacodynamic and Pharmacokinetic Properties, and Therapeutic Use in Cancer Chemotherapy
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.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
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?
In the citing paper
“Doxorubicin that has a broad spectrum of activity both in experimental tumor models and in human malignancy, affects both DNA and RNA synthesis [22].”
From Chemotherapeutic treatment efficacy and sensitivity are increased by adjuvant alternating electric fields (TTFields) (2009) · cites this paper as [22]
Citations
Cites
Risk Factors for Doxorubicin-lnduced Congestive Heart Failure
Hoff, D. D. V., LAYARD, M. W., BASA, P., DAVIS, H. L., HOFF, A. L. V., ROZENCWEIG, M., & MUGGIA, F. M. (1979) · Annals of Internal Medicine · doi:10.7326/0003-4819-91-5-710 · Cited by 2,388
Fisher, B., Bauer, M., Margolese, R. G., POISSON, R., Pilch, Y. H., Redmond, C. K., Fisher, E. R., Wolmark, N., Deutsch, M., Montague, E. D., et al. (1985) · New England Journal of Medicine · doi:10.1056/nejm198503143121101 · Cited by 2,195
Systemic treatment of early breast cancer by hormonal, cytotoxic, or immune therapy
Early Breast Cancer Trialist's Collaborative Group (1992) · The Lancet · doi:10.1016/0140-6736(92)90997-h · Cited by 2,169
Adriamycin-Induced DNA Damage Mediated by Mammalian DNA Topoisomerase II
Tewey, K. M., Rowe, T. C., Yang, L., Halligan, B. D., & Liu, L. F. (1984) · Science · doi:10.1126/science.6093249 · Cited by 1,542
McGuire, W. P., Rowinsky, E. K., Rosenshein, N. B., Grumbine, F. C., Ettinger, D. S., Armstrong, D. K., & Donehower, R. C. (1989) · Annals of Internal Medicine · doi:10.7326/0003-4819-111-4-273 · Cited by 1,100
Effects of Adjuvant Tamoxifen and of Cytotoxic Therapy on Mortality in Early Breast Cancer
Early Breast Cancer Trialists' Collaborative Group (1988) · New England Journal of Medicine · doi:10.1056/nejm198812293192601 · Cited by 932
The Anthracycline Antineoplastic Drugs
Young, R. C., Ozols, R. F., & Myers, C. E. (1981) · New England Journal of Medicine · doi:10.1056/nejm198107163050305 · Cited by 794
Assessment of response to therapy in advanced breast cancer
Hayward, J. L., Carbone, P. P., Heusen, J. C., KUMAOKA, S., SEGALOFF, A., & Rubens, R. D. (1977) · British Journal of Cancer · doi:10.1038/bjc.1977.42 · Cited by 715
A general mechanism for microsomal activation of quinone anticancer agents to free radicals.
Bachur, N. R., Gordon, S. L., & Gee, M. V. (1978) · PubMed · Cited by 639
Primary Chemotherapy To Avoid Mastectomy in Tumors With Diameters of Three Centimeters or More
Bonadonna, G., Veronesi, U., Brambilla, C., Ferrari, L., Luini, A., Greco, M., Bartoli, C., Yoldi, G. C. D., Zucali, R., Rilke, F. O., et al. (1990) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/82.19.1539 · Cited by 607
Cited by
Sorted by citations
Cardiotoxicity of Chemotherapeutic Agents
Pai, V. B., & Nahata, M. C. (2000) · Drug Safety · doi:10.2165/00002018-200022040-00002 · Cited by 730
Levine, M. N., Bramwell, V. H. C., Pritchard, K. I., Norris, B. D., Shepherd, L. E., Abu-Zahra, H., Findlay, B., Warr, D. G., Bowman, D., Myles, J., et al. (1998) · Journal of Clinical Oncology · doi:10.1200/jco.1998.16.8.2651 · Cited by 616
Pegram, M. D., Konecny, G., O'Callaghan, C. J., Beryt, M., Pietras, R. J., & Slamon, D. J. (2004) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djh131 · Cited by 513
Anthraquinones As Pharmacological Tools and Drugs
Malik, E. M., & Müller, C. E. (2016) · Medicinal Research Reviews · doi:10.1002/med.21391 · Cited by 454
Breast Cancer Metastasis: Mechanisms and Therapeutic Implications
Park, M., Kim, D., Ko, S., Kim, A., Mo, K., & Yoon, H. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23126806 · Cited by 442
Metadata
- Authors
- Plosker, G. L., & Faulds, D.
- Venue
- Drugs
- Published
- 1993-05
- Volume
- 45
- Issue
- 5
- Pages
- 788-856
- ISSN
- 0012-6667 (ISSN-L)
- 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