• Systemic Treatment Disease Site Group. Seymour L, Bramwell V. Use of dexrazoxane as a cardioprotectant in patients receiving doxorubicin or epirubicin chemotherapy for the treatment of cancer [full report]. Toronto (ON): Cancer Care Ontario (CCO); 2004 Jan. 23 p. (Practice guideline report; no. 12-5). [24 references]

• The evidence supports the use of dexrazoxane to protect against the cardiotoxicity associated with conventional-dose doxorubicin in patients with advanced but anthracycline-sensitive cancer, in whom the continued use of anthracycline-containing chemotherapy is indicated in the opinion of the treating physician, and who have received 300 mg/m² or more of doxorubicin.
• The evidence supports the use of dexrazoxane to protect against the cardiotoxicity associated with conventional-dose epirubicin in patients with advanced but anthracycline-sensitive cancer, in whom the continued use of anthracycline-containing chemotherapy is indicated in the opinion of the treating physician. There are no data indicating the optimal cumulative dose of epirubicin at which dexrazoxane should be instituted. For doxorubicin, use of dexrazoxane is recommended after the cumulative dose reaches 300 mg/m² (i.e., 55% of the recommended maximum). A similar formula could be used for epirubicin; that is, institution of dexrazoxane when the cumulative dose of epirubicin reaches 550 mg/m², as the recommended maximum cumulative dose in Canada is 1,000 mg/m².
• Preclinical studies did not show any cardioprotectant effect for dexrazoxane when used with mitoxantrone, and no clinical studies have been done. Therefore, dexrazoxane is not recommended for use with mitoxantrone.

None provided

The recommendations are supported by randomized controlled trials and a meta-analysis.

• Systemic Treatment Disease Site Group. Seymour L, Bramwell V. Use of dexrazoxane as a cardioprotectant in patients receiving doxorubicin or epirubicin chemotherapy for the treatment of cancer [full report]. Toronto (ON): Cancer Care Ontario (CCO); 2004 Jan. 23 p. (Practice guideline report; no. 12-5). [24 references]

Not applicable: The guideline was not adapted from another source.

1998 November 16 (revised online 2004 Jan)

Program in Evidence-based Care - State/Local Government Agency [Non-U.S.]

The Practice Guidelines Initiative (PGI) is the main project of the Program in Evidence-based Care (PEBC), a Province of Ontario initiative sponsored by Cancer Care Ontario and the Ontario Ministry of Health and Long-Term Care.

Cancer Care Ontario
Ontario Ministry of Health and Long-Term Care

Provincial Systemic Treatment Disease Site Group

Members of the Systemic Treatment Disease Site Group (DSG) disclosed potential conflict of interest information.

None available

This summary was completed by ECRI on August 19, 1999. The information was verified by the guideline developer as of September 17, 1999. This NGC summary was updated by ECRI on December 14, 2001. The update information was verified by the guideline developer as of January 10, 2002. This summary was updated again on October 29, 2002. The information was verified by the guideline developer on November 15, 2002. This summary was updated again on June 29, 2004. The information was verified by the guideline developer on July 19, 2004.