Iron Chelator Can Reduce Cardiac Toxicity From Some Pediatric Chemotherapy

MedicalResearch.com Interview with:

Steven E. Lipshultz, MD, FAAP, FAHA Schotanus Family Endowed Chair of Pediatrics / Carman and Ann Adams Endowed Chair in Pediatric Research / Professor, Carman and Ann Adams Department of Pediatrics / Professor of Medicine (Cardiology), Oncology, Obstetrics/Gynecology, Molecular Biology/Genetics, Family Medicine/Public Health Sciences, & Pharmacology / Member, Center for Urban Responses to Environmental Stressors, Wayne State University School of Medicine / Professor in the Center for Molecular Medicine and Genetics, Wayne State University School of Medicine President, University Pediatricians & Interim Director, Children’s Research Center of Michigan Pediatrician-in-Chief, Children’s Hospital of Michigan / Specialist-in-Chief, Pediatrics, Detroit Medical Center Scientific Member, Karmanos Cancer Institute, an NCI-designated Comprehensive Cancer Center

Dr. Steven Lipshultz

Steven E. Lipshultz, MD, FAAP, FAHA
Schotanus Family Endowed Chair of Pediatrics / Carman and Ann Adams Endowed Chair in Pediatric Research / Professor, Carman and Ann Adams Department of Pediatrics / Professor of Medicine (Cardiology), Oncology, Obstetrics/Gynecology, Molecular Biology/Genetics, Family Medicine/Public Health Sciences, & Pharmacology /Professor in the Center for Molecular Medicine and Genetics
Wayne State University School of Medicine
President, University Pediatricians & Interim Director, Children’s Research Center of Michigan
Pediatrician-in-Chief, Children’s Hospital of Michigan

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Surviving childhood cancer has dramatically and increasing improved to the point where more than 80% will achieve a 5-year event free survival. Many of these survivors look forward to decades of active productive life.

More than half of these survivors have been treated with therapies know to be associated with late cardiotoxicity that can be pervasive, persistent, and progressive and associated with cardiovascular morbidity and mortality. In this article we review both the course and prevention of this cardiotoxicity. We focus in part on anthracycline chemotherapy that is widely used and known to be cardiotoxicity.

We further review studies we and others have conducted to examine the effectiveness of dexrazoxane, an iron chelator, that when given before each anthracycline dose results in anthracycline cardioprotection for long term survivors. In some reported studies this has allowed for higher cumulative anthracycline doses to be safely given. In other cases this has allowed for simultaneously being able to safely treat children with malignancies that would be refractory to conventional therapy more potent therapies that would normally have additive cardiotoxicity.

MedicalResearch.com: What should readers take away from your report?

Response: Anthracycline therapy for childhood cancer is often effective but the price of a cure can be late cardiotoxicity in long term survivors. This late anthracycline cardiotoxicity can be ameliorated or prevented by using the cardio protectant dexrazoxane.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Children living with and beyond childhood cancer treated with anthracycline chemotherapy should be treated with dexrazoxane before each anthracycline dose in the setting of protocols that monitor oncologic efficacy and cardiotoxicity across the lifespan.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Kelley K. Hutchins, Hani Siddeek, Vivian I. Franco, Steven E. Lipshultz. Prevention of cardiotoxicity among survivors of childhood cancer. British Journal of Clinical Pharmacology, 2016; DOI: 10.1111/bcp.13120

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