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The first anthracycline discovered was daunorubicin (trade name Daunomycin), which is produced naturally by Streptomyces peucetius, a species of Actinomycetota. Clinically the most important anthracyclines are doxorubicin, daunorubicin, epirubicin and idarubicin. [5]
Doxorubicin, sold under the brand name Adriamycin among others, is a chemotherapy medication used to treat cancer. [10] This includes breast cancer, bladder cancer, Kaposi's sarcoma, lymphoma, and acute lymphocytic leukemia. [10] It is often used together with other chemotherapy agents. [10] Doxorubicin is given by injection into a vein. [10]
Daunorubicin: IV: Inhibits DNA and RNA synthesis by intercalating DNA base pairs. Inhibits DNA repair by inhibiting topoisomerase II. Acute leukaemias: Myelosuppression, cardiotoxicity, anaphylaxis (rare), secondary malignancies (particularly acute myeloid leukaemia and myelodysplastic syndrome) and radiation recall. Doxorubicin: IV: As above.
Daunorubicin is in the anthracycline family of medication. [3] It works in part by blocking the function of topoisomerase II. [2] Daunorubicin was approved for medical use in the United States in 1979. [2] It is on the World Health Organization's List of Essential Medicines. [4] It was originally isolated from bacteria of the Streptomyces type. [5]
[9] [10] Area under the plasma concentration versus time curve values (adjusted for dose) are 1.3 to 1.7 times higher for doxorubicin than epirubicin following single-dose intravenous administration. [ 5 ] [ 7 ] Epirubicin shows a 77% binding to plasma proteins, predominantly albumin, which is not affected by drug concentration.
A bisantrene combination treatment is currently (as at early 2024) nearing the end of a Phase II clinical trial to assess its efficacy in treating AML in heavily pretreated patients and to assess any adverse side effects, including any cardiotoxicity of the combination. The December 2023 interim findings are given in the History section. [5]
Cardiotoxicity may be caused by chemotherapy (a usual example is the class of anthracyclines) [3] [4] treatment and/or radiotherapy; [5] complications from anorexia nervosa; adverse effects of heavy metals intake; [6] the long-term abuse of or ingestion at high doses of certain strong stimulants such as cocaine; [7] or an incorrectly ...
Cardiotoxicity (heart damage) is especially prominent with the use of anthracycline drugs (doxorubicin, epirubicin, idarubicin, and liposomal doxorubicin). The cause of this is most likely due to the production of free radicals in the cell and subsequent DNA damage .