# Anthracyclines (doxorubicin, epirubicin)

Source: https://onco.cc/terms/anthracycline/  
OnCo record `anthracycline` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A family of red chemotherapy drugs derived from a soil bacterium that damage cancer DNA. Cornerstones of breast cancer, lymphoma, leukaemia and sarcoma treatment, but they weaken the heart in a dose-dependent way, so there is a lifetime limit.

## Summary

Doxorubicin, epirubicin, daunorubicin and idarubicin intercalate DNA and poison topoisomerase II. They anchor AC/EC in breast cancer, CHOP in lymphoma, 7+3 in AML and doxorubicin-ifosfamide in sarcoma. Cumulative doses above about 450 mg/m² doxorubicin cause cardiomyopathy, and even lower doses matter in children and with trastuzumab, which motivates anthracycline-free regimens (TCHP, docetaxel-cyclophosphamide), dexrazoxane, liposomal formulations and cardiac surveillance. They also cause alopecia, myelosuppression, and secondary leukaemia (topoisomerase-related, 1-2%), and as ADC payloads they are being revisited.

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: anthracyclines; anthracycline-based; anthracycline-free; anthracycline-containing; liposomal doxorubicin; AC-T; FEC; anthracycline cardiotoxicity

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Anthracycline
- Wikipedia: https://en.wikipedia.org/wiki/Anthracycline

## Connected records

- terms: [7+3 induction chemotherapy](https://onco.cc/terms/seven-plus-three/), [Cardiotoxicity (LVEF decline, cardiomyopathy)](https://onco.cc/terms/cardiotoxicity/), [Infusion reactions, hypersensitivity and extravasation](https://onco.cc/terms/extravasation-infusion-reaction/), [R-CHOP (lymphoma chemoimmunotherapy)](https://onco.cc/terms/r-chop/), [Secondary malignancy (therapy-related cancer)](https://onco.cc/terms/secondary-malignancy/)
- cancers: [Acute myeloid leukaemia](https://onco.cc/cancers/aml/), [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/), [Sarcomas (soft tissue, bone, GIST)](https://onco.cc/cancers/sarcoma/), [Triple-negative breast cancer (TNBC)](https://onco.cc/cancers/tnbc/)
- fronts: [Chemotherapy](https://onco.cc/fronts/chemotherapy/)
- technologies: [Cardio-oncology](https://onco.cc/technologies/cardio-oncology/), [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Strain echocardiography (global longitudinal strain)](https://onco.cc/technologies/strain-echocardiography-gls/), [Troponin and natriuretic peptide monitoring during cancer treatment](https://onco.cc/technologies/cardiac-biomarker-monitoring/)
- drugs: [Doxorubicin](https://onco.cc/drugs/doxorubicin/)
- key papers: [Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials](https://onco.cc/key-papers/paper-ebctcg-polychemotherapy-regimens-meta-analysis-lancet-2012/), [Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline](https://onco.cc/key-papers/paper-asco-neoadjuvant-therapy-breast-guideline-jco-2021/)
- roadmaps: [Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem](https://onco.cc/roadmaps/tnbc-roadmap/)
- ideas: [Give exceptional responders less: pembrolizumab omission after complete response, anthracycline-free regimens and chemotherapy omission in lymphocyte-rich stage I disease](https://onco.cc/ideas/idea-tnbc-de-escalation-for-exceptional-responders/)

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