Cited by 1,509Chemotherapy-induced cardiotoxicity and mitigationBioactive Compounds and Antitumor AgentsCancer therapeutics and mechanisms

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Doxorubicin: The Good, the Bad and the Ugly Effect

Carvalho, Cristina, Santos, Renato, Cardoso, Susana, Correia, Sonia, Oliveira, Paulo, Santos, Maria, Moreira, Paula·2009·Current Medicinal Chemistry

DOI 10.2174/092986709788803312

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Abstract

The anthracycline doxorubicin (DOX) is widely used in chemotherapy due to its efficacy in fighting a wide range of cancers such as carcinomas, sarcomas and hematological cancers. Despite extensive clinical utilization, the mechanisms of action of DOX remain under intense debate. A growing body of evidence supports the view that this drug can be a double-edge sword. Indeed, injury to nontargeted tissues often complicates cancer treatment by limiting therapeutic dosages of DOX and diminishing the quality of patients' life during and after DOX treatment. The literature shows that the heart is a preferential target of DOX toxicity. However, this anticancer drug also affects other organs like the brain, kidney and liver. This review is mainly devoted to discuss the mechanisms underlying not only DOX beneficial effects but also its toxic outcomes. Additionally, clinical studies focusing the therapeutic efficacy and side effects of DOX treatment will be discussed. Finally, some potential strategies to attenuate DOX-induced toxicity will be debated.

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BackgroundInfluential
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Influential
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Jagetia, G. C., & Hmingthazuali, V. L. (2018) · Annals of Clinical and Laboratory Research · doi:10.21767/2386-5180.1000224 · Cited by 6
“Doxorubicin is an important antibiotic which is in frequent clinical use to treat different cancers either alone or in combination with other chemotherapeutic drugs [6].”
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Linking the thermostability of FIP-nha (Nectria haematococca) to its structural properties
Liu, Y., Bastiaan‐Net, S., Zhang, Y., et al. (2022) · International Journal of Biological Macromolecules · doi:10.1016/j.ijbiomac.2022.05.136 · Cited by 6
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“The latter is correlated to the cumulative dose used and is manifested mainly as cardiotoxicity that could potentially lead to congestive heart failure (CHF) [2] causing up to 50% mortality [3].”
Background
Combination therapy of Doxorubicin with TTFields and radiation: Newer approaches to combat lung cancer
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“However, the clinical use of DOX is limited due to its severe side effects, such as cardiotoxicity, myelosuppression, and the development of multidrug resistance [6].”
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Vernonia amygdalina protects against doxorubicin-induced hepatic and renal damage in rats: mechanistic insights
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“The spheroids were treated with Doxorubicin [29] after two days concentrations (10; 3.33; 1.11; 0.370; 0.123; 0.0412; 0.0137; 0.00457; 0.00152; 0 µ M) of Doxorubicin.”
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The Grape Fruit Bioflavonoid Naringin Protects Against the Doxorubicin-Induced Micronuclei Formation in Mouse Bone Marrow
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Role of non-coding RNAs in cardiotoxicity of chemotherapy
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“Other related mechanisms include dysregulation of intracellular calcium, alteration of lipid metabolism and direct suppression of heart-special gene expression ([48-53]).”
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“In the case of doxorubicin, severe side effects such as cardiotoxicity could be attenuated [65].”
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Authors: Carvalho, C., Santos, R., Cardoso, S., Correia, S., Oliveira, P., Santos, M., & Moreira, P.
Affiliations: Centro de Neurociências e Biologia Celular (PT)
Corresponding author: Moreira, Paula
ORCID: Carvalho, Cristina
Santos, Renato
Cardoso, Susana
Oliveira, Paulo
Santos, Maria
Moreira, Paula
Venue: Current Medicinal Chemistry
Publisher: Bentham Science Publishers Ltd.
Published: 2009-09-01
Volume: 16
Issue: 25
Pages: 3267-3285
ISSN: 0929-8673 (ISSN-L)
DOI: 10.2174/092986709788803312
OpenAlex: W2102897174
Cited by: 1,509
References: 0
Citations by year: 2026: 102 · 2025: 147 · 2024: 174 · 2023: 169 · 2022: 153 · 2021: 150 · 2020: 120 · 2019: 85 · 2018: 84 · 2017: 53 · 2016: 63 · 2015: 62 · 2014: 43 · 2013: 35 · 2012: 29
FWCI: 14.12
Type: journal article
Language: en
Open access: closed
Locations: Current Medicinal Chemistry (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Chemotherapy-induced cardiotoxicity and mitigation
Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Bioactive Compounds and Antitumor Agents
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Cancer therapeutics and mechanisms
Keywords: doxorubicin, anthracyclines, cardiotoxicity, drug toxicity mechanisms, anticancer mechanism, neurotoxicity, nephrotoxicity, hepatotoxicity, chemotherapy side effects
MeSH terms: Antibiotics, Antineoplastic, Doxorubicin, Humans, Molecular Conformation, Neoplasms

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Doxorubicin: The Good, the Bad and the Ugly Effect

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