Abstract
A retrospective analysis was performed on the medical charts of 160 cancer patients who received esorubicin (ESO or 4′ deoxydoxorubicin) in a Phase I clinical trial. The purpose of the review was to characterize the incidence of local venous reactions to this investigational doxorubicin (DOX) analog. The impact of prophy lactic pretreatments or post-treatment using antihistamines and glucocorticosteroids was also assessed. There were 58 episodes of local reactions to ESO injections (14.3%). These reactions were characterized by local swelling, itching and erythema. Like DOX-induced venous reactions, ESO complications resolved spontane ously after several hours and did not predispose patients to skin ulceration or subsequent general hypersensiti vity reactions. Indeed, ESO reactions were more common with initial treatments at low drug doses of only 10–15 mg/M2 (p <.05 by Chi-square analysis). One case of ESO extravasation (about 5mg) was successful ly managed with topical cooling. The use of antihistamines and corticosteroids was ineffective at preventing local reactions. However, when these drugs were administered after a reaction had ensued, symptoms were lessened significantly in half of the patients treated (p <.05). The results of this review suggest that ESO causes a four-fold greater incidence of local venous reactions than with the parent DOX.
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References
Arcamone F, Penco S, Redaelli S, Hanessian S: Synthesis and antitumor activity of 4′ deoxydoxorubicin and 4′1-deoxyadriamycin J Med Chem 19:1424–1425, 1976
Casazza AM: Experimental evaluation of anthracycline analogs Cancer Treat Rep 63:835–844, 1979
Casazza AM: Antitumor activity and cardiac toxicity of 4′-deoxydoxorubicin in mice. In: G Mathe, R Mararl and R De Jager (eds): Anthracyclines Current Status and Future Developments, Masson Publishing Inc, New York, 1980, pp: 193–197
Garewal HS, Robertone A, Salmon SE, Jones SE, Alberts DS, Brooks R: Phase I trial of esorubicin (4′ deoxydoxorubicin). J Clin Oncol 2(9):1034–1039, 1984
Vogelzang NJ: “Adriamycin Flare”. A skin reaction resembling extravasation. Cancer Treat Rep 63(11–12): 2067–2069, 1979
Zar JH: Biostatistial Analysis, Prentice Hall Englewood, 1974, pp: 65–67
Etcubanas E, Wilbur JR: Uncommon side effects of Adriamycin (NSC-123127). Cancer Chemother Rep Part 1, 58(6):757–758, 1974
Souhami L, Fel R: Urticaria following intravenous doxorubicin administration. J Amer Med Assoc 240(15): 1624–1626, 1978
Hatfield AK, Harder L, Abderhalden RT: Chronic urti carial reactions caused by doxorubicin-containing regimens. Cancer Treat Rep 65(3–4):353–354, 1981
Arnold DJ, Stafford CT: Systemic allergic reaction to Adriamycin. Cancer Treat Rep 63(1):150–151, 1979
Collins JA: Hypersensitivity reaction to doxorubicin. Drug Intell Clin Pharm 18:402–403, 1984
Solimando Jr DA, Wilson JP: Doxorubicin-induced hypersensitivity reactions. Drug Intell Clin Pharm 18:808–811, 1984
Bristow MR, Sageman WS, Scott RH, Billingham ME, Bowden RE, Kernoff RS, Snidow GH, Daniels JR: Acute and chronic cardiovascular effects of doxorubicin in the dog: The cardiovascular pharmacology of drug-induced histamine release. J Cardiovasc Pharmacol 2:487–515, 1980
Riegel EA, Kaliner M, El-Hage AN:Anthracycline-induced histamine release from rat mast cells. Agents Actions 12(4):431–437, 1982
Dorr RT, Alberts DS, Stone A: Cold protection and heatenhancement of doxorubicin skin toxicity in the mouse. Cancer Treat Rep 69(4):431–437, 1985
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Lee, K.M., Dorr, R.T. & Robertone, A. High incidence of local venous reactions to esorubicin. Invest New Drugs 5, 31–35 (1987). https://doi.org/10.1007/BF00217666
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DOI: https://doi.org/10.1007/BF00217666