{"entity":{"id":"anthracycline","kind":"term","name":"Anthracyclines (doxorubicin, epirubicin)","aka":["anthracyclines","anthracycline-based","anthracycline-free","anthracycline-containing","liposomal doxorubicin","AC-T","FEC","anthracycline cardiotoxicity"],"tldr":"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.","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/Anthracycline","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Anthracycline"}],"tags":[],"related":["cardiotoxicity","secondary-malignancy","r-chop","seven-plus-three"],"cancers":["breast-hr-positive","dlbcl","aml","sarcoma"],"sections":["chemotherapy"],"technologies":["cytotoxic-chemotherapy","cardio-oncology"],"targets":[],"drugs":["doxorubicin"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Treatment jargon"},"route":"/terms/anthracycline/","neighbours":{"term":[{"id":"seven-plus-three","kind":"term","name":"7+3 induction chemotherapy","route":"/terms/seven-plus-three/"},{"id":"cardiotoxicity","kind":"term","name":"Cardiotoxicity (LVEF decline, cardiomyopathy)","route":"/terms/cardiotoxicity/"},{"id":"extravasation-infusion-reaction","kind":"term","name":"Infusion reactions, hypersensitivity and extravasation","route":"/terms/extravasation-infusion-reaction/"},{"id":"r-chop","kind":"term","name":"R-CHOP (lymphoma chemoimmunotherapy)","route":"/terms/r-chop/"},{"id":"secondary-malignancy","kind":"term","name":"Secondary malignancy (therapy-related cancer)","route":"/terms/secondary-malignancy/"}],"cancer":[{"id":"aml","kind":"cancer","name":"Acute myeloid leukaemia","route":"/cancers/aml/"},{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"sarcoma","kind":"cancer","name":"Sarcomas (soft tissue, bone, GIST)","route":"/cancers/sarcoma/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"}],"technology":[{"id":"cardio-oncology","kind":"technology","name":"Cardio-oncology","route":"/technologies/cardio-oncology/"},{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"strain-echocardiography-gls","kind":"technology","name":"Strain echocardiography (global longitudinal strain)","route":"/technologies/strain-echocardiography-gls/"},{"id":"cardiac-biomarker-monitoring","kind":"technology","name":"Troponin and natriuretic peptide monitoring during cancer treatment","route":"/technologies/cardiac-biomarker-monitoring/"}],"drug":[{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"}],"paper":[{"id":"paper-ebctcg-polychemotherapy-regimens-meta-analysis-lancet-2012","kind":"paper","name":"Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials","route":"/key-papers/paper-ebctcg-polychemotherapy-regimens-meta-analysis-lancet-2012/"},{"id":"paper-asco-neoadjuvant-therapy-breast-guideline-jco-2021","kind":"paper","name":"Neoadjuvant Chemotherapy, Endocrine Therapy, and Targeted Therapy for Breast Cancer: ASCO Guideline","route":"/key-papers/paper-asco-neoadjuvant-therapy-breast-guideline-jco-2021/"}],"roadmap":[{"id":"tnbc-roadmap","kind":"roadmap","name":"Triple-negative breast cancer roadmap: from a remainder defined by three negative tests to immunotherapy, antibody-drug conjugates and the residual disease problem","route":"/roadmaps/tnbc-roadmap/"}],"idea":[{"id":"idea-tnbc-de-escalation-for-exceptional-responders","kind":"idea","name":"Give exceptional responders less: pembrolizumab omission after complete response, anthracycline-free regimens and chemotherapy omission in lymphocyte-rich stage I disease","route":"/ideas/idea-tnbc-de-escalation-for-exceptional-responders/"}]}}