{"entity":{"id":"dexrazoxane","kind":"drug","name":"Dexrazoxane","aka":["Cardioxane","Savene"],"tldr":"Dexrazoxane protects the heart from the cumulative damage of doxorubicin in women with metastatic breast cancer who need to keep receiving it, and, as Totect, limits tissue destruction when an anthracycline leaks out of a vein.","summary":"Dexrazoxane (Zinecard) was approved in May 1995 to reduce the incidence and severity of doxorubicin cardiomyopathy in women with metastatic breast cancer who have received a cumulative 300 mg/m2 and will continue doxorubicin, on randomised trials that markedly reduced cardiac events; it is not used from the start of treatment because of an early signal of reduced response, later not confirmed. Totect was approved in 2007 for anthracycline extravasation, given within six hours on three consecutive days, on two single-arm European studies in which surgery was avoided in the great majority. Dexrazoxane is also used in paediatric leukaemia and lymphoma protocols to protect against late cardiotoxicity, an area where long-term Children's Oncology Group follow-up has been reassuring about secondary malignancy. Myelosuppression adds to that of chemotherapy.","status":"approved","asOf":"2026-09-10","wikipedia":"https://en.wikipedia.org/wiki/Dexrazoxane","links":[{"label":"US label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=dexrazoxane"},{"label":"NCI drug page","url":"https://www.cancer.gov/about-cancer/treatment/drugs/dexrazoxanehydrochloride"}],"tags":["nci-list","supportive"],"related":["doxorubicin"],"cancers":["breast-hr-positive","all-leukemia"],"sections":[],"technologies":["cardio-oncology"],"targets":[],"drugs":[],"companies":["pfizer","kissei"],"institutions":[],"pathways":[],"terms":[],"trials":["nct06220032","nct00016276","nct04293562"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Zinecard / Totect","modality":"Cardioprotectant and extravasation antidote (bisdioxopiperazine)","supportive":true,"mechanism":"Cyclic EDTA derivative hydrolysed intracellularly to a metal chelator that removes iron from anthracycline-iron complexes, limiting free-radical cardiac injury; also a catalytic topoisomerase II inhibitor, which underlies its action against extravasation injury.","approvals":[{"region":"US","year":1995,"indication":"Reduction of doxorubicin cardiomyopathy in women with metastatic breast cancer after 300 mg/m2 cumulative dose (Zinecard)"},{"region":"US","year":2007,"indication":"Anthracycline extravasation (Totect)"}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[{"date":"1995-05-26","type":"accelerated-approval","region":"US","note":"Accelerated approval on a surrogate endpoint, with a confirmatory trial required.","indication":"Supportive Care: Prevention of cardiomyopathy associated with doxorubicin administration"},{"date":"2002-10-31","type":"conversion","region":"US","note":"Confirmed: the accelerated approval of 1995 converted to traditional approval 7.4 years after it was granted.","indication":"Supportive Care: Prevention of cardiomyopathy associated with doxorubicin administration"}]},"route":"/drugs/dexrazoxane/","neighbours":{"drug":[{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"}],"cancer":[{"id":"all-leukemia","kind":"cancer","name":"Acute lymphoblastic leukaemia","route":"/cancers/all-leukemia/"},{"id":"aml-paediatric","kind":"cancer","name":"Acute myeloid leukaemia in children","route":"/cancers/aml-paediatric/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"}],"technology":[{"id":"cardio-oncology","kind":"technology","name":"Cardio-oncology","route":"/technologies/cardio-oncology/"},{"id":"anthracycline-cardioprotection","kind":"technology","name":"Protecting the heart during anthracycline treatment: dexrazoxane, beta blockers and ACE inhibitors","route":"/technologies/anthracycline-cardioprotection/"},{"id":"strain-echocardiography-gls","kind":"technology","name":"Strain echocardiography (global longitudinal strain)","route":"/technologies/strain-echocardiography-gls/"},{"id":"rejuv-paed-heart","kind":"technology","name":"The heart after anthracyclines and chest radiotherapy in childhood","route":"/technologies/rejuv-paed-heart/"},{"id":"cardiac-biomarker-monitoring","kind":"technology","name":"Troponin and natriuretic peptide monitoring during cancer treatment","route":"/technologies/cardiac-biomarker-monitoring/"}],"company":[{"id":"kissei","kind":"company","name":"Kissei Pharmaceutical","route":"/companies/kissei/"},{"id":"pfizer","kind":"company","name":"Pfizer (incl. Seagen)","route":"/companies/pfizer/"}],"trial":[{"id":"nct04293562","kind":"trial","name":"A Study to Compare Standard Chemotherapy to Therapy With CPX-351 and/or Gilteritinib for Patients With Newly Diagnosed AML With or Without FLT3 Mutations","route":"/trials/nct04293562/"},{"id":"nct00016276","kind":"trial","name":"Combination Chemotherapy, Surgery, and Radiation Therapy With or Without Dexrazoxane and Trastuzumab in Treating Women With Stage III or Stage IV Breast Cancer","route":"/trials/nct00016276/"},{"id":"nct06220032","kind":"trial","name":"Prevention of Anthracycline-Induced Cardiac Dysfunction With Dexrazoxane in Patients With Diffuse Large-B Cell Lymphoma","route":"/trials/nct06220032/"}],"roadmap":[{"id":"chemotherapy-roadmap","kind":"roadmap","name":"Chemotherapy roadmap: mustard gas → curative combinations → the warhead inside smarter drugs","route":"/roadmaps/chemotherapy-roadmap/"},{"id":"paediatric-oncology-roadmap","kind":"roadmap","name":"Paediatric oncology roadmap: cooperative-group cures → engineered immunity → drugs developed for children first","route":"/roadmaps/paediatric-oncology-roadmap/"},{"id":"survivorship-roadmap","kind":"roadmap","name":"Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards","route":"/roadmaps/survivorship-roadmap/"}]}}