{"entity":{"id":"epirubicin","kind":"drug","name":"Epirubicin","aka":["Pharmorubicin"],"tldr":"Epirubicin (Ellence) is a close relative of doxorubicin used mainly after breast cancer surgery when lymph nodes are involved, and in stomach cancer regimens; it is a little kinder to the heart.","summary":"Epirubicin was approved by the FDA in 1999 as a component of adjuvant therapy for axillary node-positive breast cancer, based on the Canadian MA.5 (CEF versus CMF) and French FASG trials in which epirubicin-containing regimens improved relapse-free and overall survival. Outside the US it has been used far more widely since the 1980s, including in the ECF/EOX regimens for gastro-oesophageal cancer (REAL-2) and in FEC-docetaxel sequences for breast cancer. Cardiotoxicity is cumulative-dose dependent (the label caps lifetime exposure at 900 mg/m2), secondary acute myeloid leukaemia is a recognised late effect, and it is a vesicant.","status":"approved","asOf":"2026-09-10","wikipedia":"https://en.wikipedia.org/wiki/Epirubicin","links":[{"label":"US label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=epirubicin"},{"label":"NCI drug page","url":"https://www.cancer.gov/about-cancer/treatment/drugs/epirubicinhydrochloride"}],"tags":["nci-list","generic"],"related":["doxorubicin"],"cancers":["breast-hr-positive","breast-her2-positive","tnbc","gastric"],"sections":[],"technologies":["cytotoxic-chemotherapy","topoisomerase-inhibitors"],"targets":[],"drugs":[],"companies":["pfizer"],"institutions":[],"pathways":[],"terms":[],"trials":["nct03725059","nct06227117","nct06389006","nct06966700","nct06797635","nct06112379"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"brand":"Ellence","modality":"Anthracycline (topoisomerase II inhibitor)","mechanism":"4'-epimer of doxorubicin; intercalates DNA and inhibits topoisomerase II, with less cardiotoxicity per milligram than doxorubicin.","approvals":[{"region":"US","year":1999,"indication":"Adjuvant therapy for axillary node-positive breast cancer"}],"mechanismSteps":[],"toxicity":[],"access":[],"regulatoryEvents":[]},"route":"/drugs/epirubicin/","neighbours":{"drug":[{"id":"doxorubicin","kind":"drug","name":"Doxorubicin","route":"/drugs/doxorubicin/"}],"cancer":[{"id":"tnbc-early","kind":"cancer","name":"Early triple-negative breast cancer","route":"/cancers/tnbc-early/"},{"id":"gastric","kind":"cancer","name":"Gastric & gastro-oesophageal junction cancer","route":"/cancers/gastric/"},{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"tnbc","kind":"cancer","name":"Triple-negative breast cancer (TNBC)","route":"/cancers/tnbc/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"cardiotoxicity-surveillance-recovery","kind":"technology","name":"Heart function after anthracyclines, trastuzumab and chest radiotherapy","route":"/technologies/cardiotoxicity-surveillance-recovery/"},{"id":"anthracycline-cardioprotection","kind":"technology","name":"Protecting the heart during anthracycline treatment: dexrazoxane, beta blockers and ACE inhibitors","route":"/technologies/anthracycline-cardioprotection/"},{"id":"rejuv-paed-heart","kind":"technology","name":"The heart after anthracyclines and chest radiotherapy in childhood","route":"/technologies/rejuv-paed-heart/"},{"id":"topoisomerase-inhibitors","kind":"technology","name":"Topoisomerase-I inhibitors (and ADC payloads)","route":"/technologies/topoisomerase-inhibitors/"}],"company":[{"id":"pfizer","kind":"company","name":"Pfizer (incl. 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