complicado mecanismo de acción antitumoral como con sus efectos .. inhibidores de la topoisomerasa II (doxorrubicina, etopósido. mecanismo de acción de antineoplasicos. AV Doxorrubicina (antraciclina). – Lesión del ADN. –Inhibición topoisomerasa II. –Vía intravenosa. Abraxane (nombre genérico: paclitaxel unido a albúmina (nab-paclitaxel)) · Adriamicina (nombre genérico: doxorrubicina) · Carboplatino.
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Age does affect the clearance of epirubicin in female patients.
The decreased incidence of clinically significant cardiac doxorrkbicina associated with epirubicin as compared to doxorubicin is due to the more rapid clearance of epirubicin and possibly, glucuronidation of epirubicin. Anaphylactoid reactions and urticaria may occur following epirubicin administration. Females and children may be more sensitive to the cardiotoxic effects of anthracyclines.
The dose of epirubicin should be adjusted for elevations in the total bilirubin or AST because these patients will have a decreased clearance of epirubicin with an increase in overall toxicity see Dosage.
Alopecia occurs in almost all patients receiving epirubicin therapy. First-line chemotherapy with epirubicin, paclitaxel, and carboplatin for advanced ovarian cancer: La epirubicina tiene un espectro similar de actividad y de toxicidad a los de la doxorrubicina. Those undergoing chemotherapy should not be exposed to others who have recently received the oral poliovirus vaccine OPV.
Overall, recurrence rates with epirubicin or intravesical BCG are similar except in patients with poorly differentiated tumors G3 or tumor restricted to the lamina propria of the bladder T1 where epirubicin is associated with a higher recurrance rate. The severity of the suppression depends on the dose of the drug and the regenerative capacity of the patient’s bone marrow.
Symptoms may last up to an hour and may be treated with steroids, antihistamines and ice packs. Patients should be closely monitored during IV infusions for signs and symptoms of extravasation such as poor blood return, burning, stinging, and doxorgubicina at the injection site.
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Occurrence of secondary malignancy, usually acute myeloid leukemia with or without a preleukemic phase, has been reported following epirubicin. The French Epirubicin Study Group. In addition, epirubicin has a lower incidence of cardiotoxicity; the maximum cumulative dose is almost twice that of doxorubicin.
In two European phase III trials comparing epirubicin FEC and doxorubicin CAF in combination with cyclophosphamide and fluorouracil for the treatment of breast cancer, the patients treated with epirubicin had similar response and survival rates as patients treated with doxorubicin.
Accin creatinine levels should be assessed before and during epirubicin treatment. Some antineoplastic agents have been reported to decrease the absorption of digoxin tablets due to their adverse effects on the GI mucosa; no significant change was seen with digoxin capsules, and the effect on digoxin liquid is not known. Epirubicin has been designated an orphan drug by the FDA for this indication.
Other mechanisms of resistance include changes in topoisomerase II and glutathione activity. Standard- and high-dose etoposide, ifosfamide, carboplatin, and etoposide in patients with small-cell lung cancer: Patients with hepatic impairment: Women of childbearing potential should be warned against getting pregnant. Epirubicin also affects topoisomerase II, an enzyme responsible for DNA strand breaks during doxorrubicinw.
Multicenter randomized clinical trial on high-dose epirubicin plus cis-platinum versus vinorelbine plus cis-platinum in advanced non-small cell lung cancer. J Clin Oncol ;6: Oncology Huntingt ;12 1 Suppl 1: Nail discoloration, photosensitivity, and skin discoloration have been reported. Epirubicin-derived free radicals can induce membrane lipid peroxidation, DNA strand scission, and direct oxidation of purine or pyrimidine bases, thiols and amines.
Epirubicin should not be administered during pregnancy because of the possibility of teratogenic effects.
EPIRUBICINA EN VADEMECUM
Epirubicin-induced free radical formation contributes to its cardiotoxicity. Epirubicin was granted orphan drug status for the treatment of breast cancer prior to approval in the United States. The addition doxrorubicina cyclosporine or valspodar to epirubicin therapy may result in increases in AUC for both epirubicin and epirubicinol possibly due to a decrease in clearance of parent drug, a decrease in metabolism of epirubicinol, or an increase in intracellular epirubicin concentrations.
These agents could enhance epirubicin’s activity. Both cardiac and malignant cells are rich in mitochondria. Outpatient treatment with epirubicin and oral etoposide in patients with small-cell lung cancer. Regrowth of hair usually resumes 3 weeks after therapy has been discontinued. Cyclosporine, valspodar PSCtrifluoperazine, tamoxifen, toremifene, and verapamil all block the multidrug resistance MDR glycoprotein, which is a mechanism of resistance to naturally occurring non-synthetic chemotherapy agents.
Metabolism of epirubicin occurs through four major routes: The ECF regimen resulted in an increased response and survival benefit for patients with previously untreated gastric cancer or head and neck cancer. J Clin Oncol ; Due to rapid lysis of chemosensitive cells by epirubicin, serum uric mecanismk levels may increase.
Concurrent use of epirubicin with other agents that cause bone marrow or immune suppression such as other antineoplastic agents or immunosuppressives may result in additive effects. Clinicians should consult the appropriate references to verify the dose.