dexrazoxane / Generic mfg. - LARVOL DELTA

Cardiovascular and Survival Outcomes Among Adults With Hematologic Malignancies Receiving Anthracyclines With vs Without Dexrazoxane: A Real-World Propensity-Matched Analysis (SOHO 2026) - "Patients: Adults aged 18–75 years with a hematologic malignancy (ALL; AML; CLL; CML; Hodgkin lymphoma; DLBCL; follicular, mantle cell, or mature T/NK lymphoma; multiple myeloma; MDS; polycythemia vera) diagnosed on/after January 1, 2010, initiating an anthracycline (daunorubicin, doxorubicin, epirubicin, idarubicin, mitoxantrone) within 3 months of diagnosis, with (n = 1887) or without (n = 40607) concurrent dexrazoxane. Dexrazoxane was paradoxically associated with higher cardiomyopathy, heart failure, MACE, and mortality, contrary to randomized cardioprotection trials. These results almost certainly reflect channeling bias: dexrazoxane is preferentially given to patients receiving high cumulative anthracycline doses or with preexisting/emerging cardiotoxicity, which are not captured by administrative coding. ALL: acute lymphoblastic leukemia, AML: acute myeloid leukemia, CLL: chronic lymphocytic leukemia, CML: chronic myeloid leukemia, DLBCL: diffuse large B-cell..."

Clinical • Real-world • Real-world evidence • Acute Lymphocytic Leukemia • Acute Myelogenous Leukemia • B Cell Lymphoma • Chronic Lymphocytic Leukemia • Chronic Myeloid Leukemia • Diffuse Large B Cell Lymphoma • Follicular Lymphoma • Hematological Malignancies • Hodgkin Lymphoma • Leukemia • Lymphoma • Multiple Myeloma • Myelodysplastic Syndrome • Natural Killer/T-cell Lymphoma • Non-Hodgkin’s Lymphoma • Oncology • Polycythemia Vera

Venetoclax in combination with cytarabine with or without idarubicin or azacitidine in children, adolescents, and young adults with relapsed or refractory acute myeloid leukaemia (VENAML): a multicentre, phase 1 expansion study. (PubMed, Lancet Haematol) - P1, P3 | "Venetoclax with high-dose cytarabine is active with acceptable safety in paediatric patients with relapsed or refractory AML. These findings support ongoing research of venetoclax with high-dose cytarabine in this population, including the randomised paediatric phase 3 trial (NCT05183035)."

Journal • P1 data • Acute Myelogenous Leukemia • Febrile Neutropenia • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hematological Malignancies • Immunology • Infectious Disease • Leukemia • Neutropenia • Oncology • Pediatrics • Septic Shock

Progression-Free Survival (PFS) and Toxicity with Nivolumab-AVD Compared to Brentuximab Vedotin-AVD in Pediatric Advanced Stage (AS) Classic Hodgkin Lymphoma (cHL), Results of SWOG S1826 (ASH 2023) - P3 | "Dexrazoxane was permitted, but not mandated. In early follow-up, N-AVD and BV-AVD are well tolerated and associated with low rates of irAEs in pts ages 12-17 y. With 12.1 mos median follow-up the PFS benefit observed for N-AVD in pediatric pts mirrors that observed in the overall study. RT usage is lower, and cumulative doxorubicin dose is higher than historical pediatric cHL trials. The difference in rate of discontinuation between study arms and by age group needs further evaluation."

Clinical • Metastases • Classical Hodgkin Lymphoma • Endocrine Disorders • Febrile Neutropenia • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Hematological Malignancies • Hodgkin Lymphoma • Immunology • Infectious Disease • Inflammation • Lymphoma • Neutropenia • Oncology • Pediatrics • Pneumonia • Septic Shock

PROGRESSION-FREE SURVIVAL (PFS) WITH NIVOLUMAB-AVD IS SUPERIOR TO BRENTUXIMAB VEDOTIN-AVD WITH 2-YEAR FOLLOW-UP OF S1826 IN ADOLESCENT ADVANCED STAGE (AS) CLASSIC HODGKIN LYMPHOMA (CHL) (ISHL 2024) - P3 | "80% of adolescent pts received dexrazoxane. N-AVD is well tolerated in adolescents 12–17 y, with high PFS and EFS and minimal use of RT compared to prior pediatric HL studies. N-AVD is a new standard of care for adolescents with AS cHL."

Metastases • Endocrine Disorders • Febrile Neutropenia • Hematological Disorders • Hematological Malignancies • Hodgkin Lymphoma • Infectious Disease • Lymphoma • Neutropenia • Oncology • Pain • Pediatrics • Septic Shock

A narrative review of emerging chemoprotective agents for chemotherapy-induced toxicity: nanoformulated natural products, dual COX-2/TNF-α inhibitors, and Nrf2 modulators. (PubMed, Front Pharmacol) - "Established chemoprotective agents (dexrazoxane, mesna, and amifostine) are limited by narrow indications (dexrazoxane: only anthracycline cardiotoxicity), significant adverse effects (amifostine: hypotension in 62%), and lack of efficacy against common toxicities such as peripheral neuropathy...Three major emerging categories were identified: (i) Nanoformulated natural products such as curcumin, resveratrol, luteolin, and naringenin encapsulated in polymeric, lipid, or cyclodextrin-based nanocarriers, demonstrate improved bioavailability and enhanced efficacy in preclinical models though chemoprotection-specific clinical data remain limited (ii) Dual COX-2/TNF-α inhibitors (e.g., NO-donating aspirin)...Physical strategies (limb hypothermia) and repurposed drugs (metformin) offer additional avenues but need Phase III validation...Future trials must incorporate biomarker-driven enrollment and standardized chemoprotection endpoints. Comparative analysis across categories..."

Journal • Review • Cardiovascular • Genetic Disorders • Hypotension • Oncology • Pain • CTNNB1 • STAT3

Clinical guidelines for the management of cytostatic extravasation in children. (PubMed, Contemp Oncol (Pozn)) - "Specific measures include aspiration techniques for peripheral and central lines, administration of antidotes such as dexrazoxane, dimethyl sulfoxide, or hyaluronidase, and application of cold or warm compresses depending on the cytostatic agent...Early use of specific antidotes and supportive measures can prevent irreversible damage, while preventive strategies and vigilant monitoring remain crucial. Surgical interventions should be reserved for severe, non-responsive cases."

Clinical guideline • Journal • Review • Aesthetic Medicine • Oncology • Pain • Pediatrics

Dexrazoxane and Long-Term Heart Function in Survivors of Childhood Cancer. (PubMed, J Clin Oncol) - "Among young adult-aged survivors of childhood cancer, dexrazoxane was associated with a cardioprotective effect nearly 20 years after initial anthracycline exposure."

Journal • Acute Lymphocytic Leukemia • Hematological Malignancies • Hodgkin Lymphoma • Leukemia • Lymphoma • Oncology • Osteosarcoma • Sarcoma • Solid Tumor

Intravenous Dexrazoxane for Hemorrhagic Myocardial Infarction in STEMI: A Double-Blind, Placebo-Controlled, Sequential-Cohort Phase IIa Trial (SHIELD-MI) (ESC 2026) - No abstract available

Clinical • Late-breaking abstract • P2a data • Cardiovascular • Myocardial Infarction

Intravenous dexrazoxane for haemorrhagic myocardial infarction: the SHIELD-MI study. (PubMed, Eur Heart J) - "Peri-procedural intravenous DXZ was associated with lower IMH and infarct size and higher LVEF, without safety concerns. These exploratory findings identify IMH as a candidate therapeutic target warranting a randomized trial."

Journal • Cardiovascular • Hematological Disorders • Myocardial Infarction • Reperfusion Injury

AALL1631: Imatinib Mesylate and Combination Chemotherapy in Treating Patients With Newly Diagnosed Philadelphia Chromosome Positive Acute Lymphoblastic Leukemia (clinicaltrials.gov) - P3 | N=352 | Active, not recruiting | Sponsor: Children's Oncology Group | Trial primary completion date: Sep 2027 ➔ Jun 2026

Trial primary completion date • Acute Lymphocytic Leukemia • B Acute Lymphoblastic Leukemia • Hematological Malignancies • Leukemia • Oncology • T Acute Lymphoblastic Leukemia • ABL1 • CSF1R • PDGFRA • PDGFRB

Erratum: Longitudinal Change in Cardiac Function After Doxorubicin and Dexrazoxane: A Report From Children's Oncology Group ALTE11C2. (PubMed, J Clin Oncol) - No abstract available

Journal • Oncology

Integrated Multi-omics Reveals CDKN1A Suppression and Metabolic Regulation as Key Mechanisms of Huangqi Guizhi Wuwu Decoction Against Doxorubicin-Induced Cardiotoxicity. (PubMed, Cardiovasc Toxicol) - "Mice were randomized into six groups: control, DOX (10 mg/kg × 2), DOX + low-dose HGWD (7 g/kg/d), DOX + high-dose HGWD (14 g/kg/d), DOX + dexrazoxane (100 mg/kg × 2), and HGWD (14 g/kg/d) alone. Furthermore, in H9c2 cells, HGWD mitigated DOX-induced apoptosis and inflammation, exhibiting cytoprotection comparable to pifithrin-α, a specific p53 inhibitor. In summary, HGWD protects against DIC by modulating a multi-target network and the suppression of CDKN1A represents a key underlying mechanism."

Journal • Cardiovascular • Inflammation • CDKN1A • IRF7

Arctigenin discovered by high-throughput screening ameliorates doxorubicin-induced cardiotoxicity as a novel natural KEAP1-NRF2 inhibitor. (PubMed, J Pharm Anal) - "Despite decades of research, dexrazoxane (DXZ) remains the only approved cardioprotectant, yet its clinical utility is constrained by potential reduction in efficacy and systemic toxicity. This binding facilitated the dissociation of NRF2 from KEAP1, resulting in reduced NRF2 ubiquitination, increased nuclear accumulation of NRF2, and enhanced transcription of downstream target genes. Collectively, our results identify ATG as a novel NRF2 activator that alleviates DIC through suppression oxidative stress and ferroptosis by directly targeting the KEAP1-NRF2-ARE axis."

Journal • Cardiovascular • Metabolic Disorders • Targeted Protein Degradation • KEAP1

Ferroptosis in Anthracycline Cardiotoxicity: Mechanisms, the Cardioprotection Paradox and the Limits of Single-Pathway Thinking. (PubMed, J Appl Toxicol) - "The discovery that doxorubicin kills cardiomyocytes substantially through ferroptosis-an iron-dependent, lipid-peroxidation-driven cell death-has reframed the mechanism and identified a defined target, and the field has rapidly populated with iron chelators, radical-trapping inhibitors and Nrf2/GPX4-activating natural products reported to protect the heart...The single approved agent, dexrazoxane, is acceptable precisely because evidence indicates it spares antitumour efficacy. The path to translatable cardioprotection therefore runs not through broad ferroptosis blockade but through cardiac- and mitochondria-selective, appropriately timed reinforcement of iron handling and lipid-peroxidation defence, validated against hard cardiac endpoints and preserved tumour control. Ferroptosis is a genuine and central mechanism of anthracycline cardiotoxicity; converting that mechanism into safe therapy is a harder problem than the current literature acknowledges."

Journal • Review • Cardiovascular • Congestive Heart Failure • Heart Failure • Oncology • AIFM2 • GPX4

Longitudinal Change in Cardiac Function After Doxorubicin and Dexrazoxane: A Report From Children's Oncology Group ALTE11C2. (PubMed, J Clin Oncol) - "Dexrazoxane exerts a significant doxorubicin cardioprotective effect on LV systolic function long term and may reduce screening needs."

Journal • Cardiomyopathy • Cardiovascular • Oncology

A bidirectional pyroptosis regulation strategy to resolve cardiotoxicity-antitumor efficacy dilemma of doxorubicin. (PubMed, Nanoscale) - "In female BALB/c mouse models, LANPs afford cardioprotection comparable to dexrazoxane (DEX), the only clinically approved cardioprotective agent against DOX, while additionally alleviating systemic toxicity, particularly bone marrow suppression, an advantage not afforded by DEX. As expected, LANPs not only preserve but also potentiate DOX-induced antitumor efficacy. This study establishes LANPs as a promising adjuvant strategy for expanding the scope of chemotherapeutic applications beyond DOX."

Journal • Cardiovascular • Oncology

CARDIOVASCULAR COMPLICATIONS OF CHEMOTHERAPY IN BREAST CANCER: A SCOPING REVIEW. (PubMed, Ann Ib Postgrad Med) - "Cardiotoxicity risk is associated with cumulative anthracycline dose, concurrent use of cardiotoxic agents such as trastuzumab, and pre-existing cardiovascular disease...Preventive strategies-including dose modification, liposomal anthracyclines, and cardioprotective agents such as dexrazoxane, beta-blockers, and ACE inhibitors-demonstrate benefit.5/13/2026. Chemotherapy-induced cardiotoxicity remains a major clinical challenge. Early detection, risk stratification, and integrated cardio-oncology care are essential to improving outcomes in breast cancer patients."

Journal • Breast Cancer • Cardiovascular • Metabolic Disorders • Oncology • Solid Tumor

The CARDIOPROTECT Trial (clinicaltrials.gov) - P2 | N=60 | Recruiting | Sponsor: Beth Israel Deaconess Medical Center | Not yet recruiting ➔ Recruiting

Enrollment open • B Cell Lymphoma • Cardiovascular • Congestive Heart Failure • Diffuse Large B Cell Lymphoma • Heart Failure • Hematological Malignancies • Indolent Lymphoma • Lymphoma • Non-Hodgkin’s Lymphoma • Oncology

Dexrazoxane for Cardioprotection During Anthracycline Therapy: A Systematic Review and Meta-Analysis. (PubMed, Can J Cardiol) - "Dexrazoxane was associated with a lower risk of clinical HF and LVEF decline without significant differences in cytopenias or oncologic response. However, the certainty of evidence was limited. Further research in contemporary cardio-oncology should focus on non-breast cancer populations, standardize outcome definitions, and evaluate alternative dosing regimens."

Journal • Retrospective data • Review • Breast Cancer • Cardiovascular • Congestive Heart Failure • Heart Failure • Hematological Disorders • Neutropenia • Oncology • Solid Tumor • Thrombocytopenia

Analysis of gene expression changes upon topobexin treatment and TOP2B-knockout in hiPSC derived cardiomyocytes. (PubMed, Biol Open) - "In addition, the differentiated WT CM were treated with dexrazoxane (ICRF-187), a TOP2 catalytic inhibitor that targets both TOP2A and TOP2B, or topobexin, a new TOP2B selective catalytic inhibitor. Topobexin inhibition partially phenocopied a TOP2B deletion and thereby providing an alternative to TOP2B gene knockout in many cell lines. In future, hiPSC derived CM with and without TOP2B and inhibition by topobexin ex vivo CM could be used to study anthracycline-induced cardiotoxicity and to screen for cardioprotectants."

Journal • Cardiovascular • TOP2A

Cardiotoxicity, survival, and dexrazoxane use in patients with soft tissue sarcoma: a Danish population‑based cohort study. (PubMed, Acta Oncol) - "Doxorubicin with olaratumab and dexrazoxane resulted in a low incidence of cardiotoxicity and OS was consistent with previously reported."

Journal • Retrospective data • Cardiovascular • Febrile Neutropenia • Oncology • Sarcoma • Soft Tissue Sarcoma • Solid Tumor

Forward genetics reveals microsporidian drug targets and recombination-based resistance. (PubMed, NPJ Antimicrob Resist) - "Using C. elegans and its natural microsporidian parasite Nematocida parisii, we serially passaged infected animals under increasing inhibitor concentrations, generating independent N. parisii strains resistant to albendazole or dexrazoxane. Our study demonstrates the utility of forward genetics for identifying microsporidian drug targets. We also find that drug resistance arises through de novo heterozygous mutations that can subsequently become homozygous, likely via mitotic recombination."

Journal

Dexrazoxane in children receiving anthracyclines: efficacy, safety, and region-specific considerations for Latin America. (PubMed, Cardiol Young) - "Dexrazoxane represents an effective cardioprotective strategy in selected high-risk paediatric patients. A risk-adapted approach balancing cardioprotection, oncologic safety, and healthcare resources is warranted."

Journal • Review • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Oncology • Pediatrics

Risk-Based Therapy in Treating Younger Patients With Newly Diagnosed Liver Cancer (clinicaltrials.gov) - P3 | N=236 | Completed | Sponsor: National Cancer Institute (NCI) | Active, not recruiting ➔ Completed | Trial completion date: Mar 2027 ➔ Mar 2026

Trial completion • Trial completion date • Hepatoblastoma • Liver Cancer • Oncology • Solid Tumor • AFP

A case of epirubicin leakage from a subcutaneously embedded central venous port. (JBCS 2026) - "Postoperative treatment was planned to change from dose-dense EC therapy (epirubicin + cyclophosphamide) to weekly PTX therapy (paclitaxel)...Treatment involved administering dexrazoxane, clobetasol propionate ointment, and cooling...In this case, the patient had a high BMI of 38 and thick subcutaneous fat, and it is hypothesized that the puncture needle was of inappropriate length and became dislodged due to body movement. [Conclusion] This case report cites relevant literature and previously published findings, along with some discussion."

Clinical • Breast Cancer • HER2 Breast Cancer • HER2 Positive Breast Cancer • Infectious Disease • Solid Tumor • HER-2