dexrazoxane / Generic mfg. - LARVOL DELTA

Cardioprotection without risk? meta-analysis of prophylactic agents in low-risk cancer patients on anthracyclines (ASH 2025) - "We included randomized controlled trials (RCTs) of prophylactic ACE inhibitors, ARBs, beta-blockers, statins, dexrazoxane, or SGLT2 inhibitors in adults without pre-existing cardiovascular risk factors...Agents studied included beta-blockers (nebivolol, carvedilol, bisoprolol), ACE inhibitors (ramipril), ARBs (telmisartan), and spironolactone. Treatment duration ranged from 4 months to 1 year; anthracycline doses reached up to 689 mg/m² (epirubicin) or 536 mg/m² (doxorubicin)...The protective benefit was greater in contexts involving higher cumulative anthracycline doses and concurrent cardiotoxic therapies such as trastuzumab...However, high heterogeneity limits firm conclusions. Given the moderate effect size and heterogeneity, further large-scale, well-formulated trials are essential to identify optimal cardioprotective agents and precise patient selection criteria."

Retrospective data • Breast Cancer • Congestive Heart Failure • Heart Failure • Oncology • Solid Tumor

Subclinical cardiac changes following CPX-351 induction in adults with favorable/intermediate-risk AML (ASH 2025) - "If lesser toxicity is shown, CPX-351 could potentially be preferred in patients withpreexisting cardiac dysfunction or elevated risk for heart failure, and may reduce the need forcardioprotective agents such as dexrazoxane. As with any recently introduced agent that may be used toreplace standard therapy, it is crucial to fully characterize any toxicity profile, including with long-termfollow-up. We previously conducted a pilot study of CPX-351 with or without gemtuzumab ozogamicin(GO) in 25 adults (age 15%, including one who met both criteria. These five patients(20%) represent the subset with significant cardiac changes.In this cohort, both EF and GLS reductions were already evident post-induction in patients with significantcardiac changes."

Clinical • Acute Myelogenous Leukemia • Alopecia • Congestive Heart Failure • Heart Failure • Immunology • Myelodysplastic Syndrome

Early cardiotoxicity and survival in pediatric Acute Myeloid Leukemia: The mediating roles of relapse and salvage chemotherapy intensity (ASH 2025) - "Early cardiotoxicity may further affect OS by limiting the use of intensiveATC-based reinduction regimens at relapse leading to reduced post-relapse survival. The new era of nearuniversal use of dexrazoxane cardioprotection in pediatric AML therapy may present opportunities forintensification of reinduction regimens with ATC at relapse."

Clinical • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Pediatrics

Initiation of ACE inhibitors or beta-blockers during frontline therapy for pediatric Acute Myeloid Leukemia and the impacts on cardiotoxicity incidence and survival outcomes: A target trial emulation (ASH 2025) - "The MSM incorporated inverse-probability-of-censoringweights to account for artificial censoring introduced by the aforementioned cloning procedure, adjustingfor both time-fixed (age, sex, race/ethnicity, cytomolecular risk, insurance, presentation acuity, trialenrollment, dexrazoxane use in induction I) and time-varying confounders (blood pressure, bacteremia,ICU-level requirements, empiric/definitive anti-infective use)...In contrast, ACEi showed no measurable benefit across anyof the evaluated outcomes. These results support further investigation into the role of BB as acardioprotective strategy during frontline chemotherapy, including evaluation of optimal initiation timingand the comparative effectiveness of different BB agents."

Clinical • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Pediatrics

Optimization of induction chemotherapy in pediatric patients with Acute Myeloid Leukemia: Real-world evidence to support removal of etoposide from induction 1 (ASH 2025) - "Introduction: Induction chemotherapy for pediatric AML has historically used cytarabine, daunorubicinand etoposide (ADE)...This may be particularlytrue in the modern era in which therapeutic intensity can be achieved by adding gemtuzumab-ozogamycin (GO)...Relatedly, most patients treated onstudy for cycle 1, stayed on for cycle 2: ADE 84% and DA 94%.We conducted two sensitivity analyses: one limited to patients diagnosed after 2020 to account fortemporal differences in pediatric AML including expanded cytomolecular and improved MRD testing,enhanced supportive care (e.g. dexrazoxane) and additional salvage options, and one restricted topatients who received GO in induction 1... These real-world data convincingly demonstrate comparable outcomes with ADE and DAwhen used in induction 1, particularly in patients who receive GO. These data suggest that DA can besafely used as standard backbone chemotherapy for pediatric patients in this cycle, which may reduceetoposide-related..."

Clinical • HEOR • Real-world • Real-world evidence • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Pediatrics

Real-world post-relapse survival outcomes in children with Acute Myeloid Leukemia by race and ethnicity (ASH 2025) - "We performed pairwise comparisonsbetween NHB and Hispanic patients against NHW patients (reference group) using chi-square andFisher's exact tests for frontline therapy characteristics (history of bacteremia/sepsis, CTCAE Grade ≥2cardiotoxicity, dexrazoxane receipt, hematopoietic stem cell transplant [HSCT] receipt in CR1, completionof frontline therapy) and clinical characteristics at relapse (early vs. late relapse, cytomolecular riskprofile, body mass index [BMI], acuity, Grade ≥2 cardiotoxicity measured by echocardiogram within 7days of relapse)... NHB children with AML experience greater than 50% increased hazard of death post-relapsecompared to NHW children, driven by poor outcomes after early relapse. This survival disparity occursdespite comparable rates of several major frontline therapy characteristics and overall rates of frontlinetherapy completion, suggesting that downstream intermediates are driving OS differences. Our dataindicate potential differences..."

Clinical • Real-world • Real-world evidence • Acute Myelogenous Leukemia • Acute Promyelocytic Leukemia • Bone Marrow Transplantation • Hematological Malignancies • Infectious Disease • Leukemia • Obesity • Septic Shock

The use and safety of peripheral intravenous catheters (PIV) vs central venous catheters (CVC) for lymphoma patients receiving frontline anthracycline-based chemotherapy: A large multicenter real-world analysis (RWA) (ASH 2025) - "Both developed localized symptoms post-infusionand were treated conservatively (DMSO/warm compresses or dexrazoxane/ice), with full symptomresolution within 1 week and 1 day, respectively... This is the largest known analysis to date evaluating the safety of PIV access foranthracycline-based chemotherapy in >1,500 lymphoma pts over a recent 15-year period, representing>9,000 total treatments with CHOP or ABVD. PIV access was found to be safe and associated with a lowrate of serious complications. Moreover, extravasation was rare and there was not a significantdifference observed between PIV and CVC use."

Clinical • Real-world • Real-world evidence • Cardiovascular • Dermatology • Diffuse Large B Cell Lymphoma • Hematological Disorders • Hematological Malignancies • Hodgkin Lymphoma • Indolent Lymphoma • Lymphoma • Mantle Cell Lymphoma • Non-Hodgkin’s Lymphoma • T Cell Non-Hodgkin Lymphoma • Venous Thromboembolism • TCL1A

AAML1831: 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 (clinicaltrials.gov) - P3 | N=1186 | Recruiting | Sponsor: Children's Oncology Group | Trial completion date: Sep 2027 ➔ Jun 2029 | Trial primary completion date: Sep 2027 ➔ Jun 2029

Trial completion date • Trial primary completion date • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Oncology • FLT3

Protective effects of biomimetic Cu-Zn-MOF against DOX-Induced cardiotoxicity through inhibiting oxidative stress and ferroptosis. (PubMed, J Nanobiotechnology) - "In all, our study demonstrates that CZM possesses excellent enzyme-mimicking activities, along with good biosafety and biocompatibility. These findings highlight CZM's potential as a novel cardioprotective drug for mitigating DIC."

Journal • Cardiovascular • Hematological Disorders • Oncology

CBFB::MYH11 Fusion Located on a Supernumerary Ring Chromosome 16 in Pediatric Acute Myeloid Leukemia: Diagnostic Challenges and Prognostic Implications. (PubMed, Genes (Basel)) - "She received induction chemotherapy with CPX-351 (liposomal daunorubicin and cytarabine), gemtuzumab and ozogamicin (GO), and the cardioprotectant dexrazoxane and achieved complete remission (CR)...The durable remission observed in this patient, despite the unusual cytogenetic presentation, provides valuable insights into therapeutic management. This report underscores the cytogenetic and molecular heterogeneity of CBFB::MYH11 AML and emphasizes the importance of comprehensive genetic profiling using advanced techniques such as chromosomal microarray and next-generation sequencing."

Journal • Acute Myelogenous Leukemia • Hematological Malignancies • Leukemia • Oncology • Pediatrics

Dexrazoxane Hydrochloride in Preventing Heart-Related Side Effects of Chemotherapy in Participants With Blood Cancers (clinicaltrials.gov) - P2 | N=100 | Recruiting | Sponsor: M.D. Anderson Cancer Center | Trial completion date: Dec 2025 ➔ Dec 2027 | Trial primary completion date: Dec 2025 ➔ Dec 2027

Adverse events • Trial completion date • Trial primary completion date • Acute Myelogenous Leukemia • Chronic Myeloid Leukemia • Hematological Malignancies • Leukemia • Myelodysplastic Syndrome • Myeloproliferative Neoplasm • Oncology • Sarcoma • Solid Tumor

CARDIOTOXICITY AND OVERALL SURVIVAL IN PATIENTS WITH SARCOMA TREATED WITH DOXORUBICIN, OLARATUMAB AND DEXRAZOXANE: A REAL-WORLD EXPERIENCE IN DENMARK (CTOS 2025) - "Administering dexrazoxane with doxorubicin in the first treatment cycle showed no statistically significant reduction in cardiotoxicity and improvement in OS. Further data from a larger retrospective study are pending."

Clinical • Real-world • Real-world evidence • Oncology • Sarcoma • Soft Tissue Sarcoma • Solid Tumor

TIME TOXICITY AND EFFECT OF CHEMOTHERAPY FOR PATIENTS WITH METASTATIC SOFT TISSUE SARCOMA - A RETROSPECTIVE REAL-WORLD STUDY OF 244 PATIENTS (CTOS 2025) - "Of these, 153 received doxorubicin with dexrazoxane, 47 received doxorubicin with olaratumab, and 44 received doxorubicin monotherapy. This study provides novel and comprehensive data on survival outcomes and treatment efficacy in patients with metastatic STS. Importantly, our findings underscore that a substantial proportion of patients' remaining lifespan is spent attending hospital, emphasizing the need to consider time toxicity in treatment decisions and shared clinical decision-making."

Metastases • Real-world • Real-world evidence • Retrospective data • Leiomyosarcoma • Oncology • Sarcoma • Soft Tissue Sarcoma • Solid Tumor

Sarcoma: Cardiovascular and Oncologic Considerations: JACC: CardioOncology State-of-the-Art Review. (PubMed, JACC CardioOncol) - "Crucially, treatment universally includes high cumulative doses of anthracyclines, requiring risk modification using dexrazoxane, infusional administration, or liposomal formulations. Furthermore, multiple other therapies for sarcoma are associated with cardiovascular side effects. This review highlights the unique aspects of care for cardiac sarcomas, cardiovascular considerations of systemic agents used to treat sarcoma, the pediatric sarcoma population, and how cardiac surveillance of sarcoma patients can be approached."

Journal • Review • Angiosarcoma • Cardiovascular • Leiomyosarcoma • Oncology • Pediatrics • Sarcoma • Solid Tumor

Curbing Anthracycline Toxicity (PRO): Dexrazoxane is the Absolute Best (AHA 2025) - No abstract available

Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Oncology

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

Chip-AML22 Master Protocol: An Open-Label Clinical Trial in Newly Diagnosed Pediatric De Novo Acute Myeloid Leukemia (AML) Patients Including a Linked Phase II Trial with Quizartinib in FLT3-ITD/NPM1wt Patients – a Study By the NOPHO-DB-SHIP Consortium (ASH 2023) - "Building on the successes achieved by the recent trial from this consortium (NOPHO-DBH AML-2012, preliminary data as per June 2023, n=878: 5-years pEFS 63%, 5-years pOS 78%), CHIP-AML22 will incorporate innovative elements, mainly the FLT3-inhibitor quizartinib (Vanflyta®) that was recently approved by the FDA and PMDA in combination with chemotherapy for the treatment of newly diagnosed adult AML patients with FLT3-ITD mutations, and gemtuzumab ozogamicin (GO, Mylotarg®) that improved outcome in adult and pediatric AML when added to chemotherapy...Further, dexrazoxane is recommended to all patients before receiving daunorubicin or mitoxantrone, aiming to prevent late-onset cardiotoxicity...Study Ri and the linked quizartinib trial are expected to open in Q4 2023. At least 15 other countries with nearly 60 sites will participate in CHIP-AML22: Belgium, Denmark, Estonia, Finland, Hong Kong, Iceland, Israel, Latvia, Lithuania, Norway, Portugal, Spain, Sweden,..."

Clinical • P2 data • Acute Myelogenous Leukemia • Cardiovascular • Hematological Malignancies • Leukemia • Oncology • Pediatrics • CBFA2T3 • CD33 • FLT3 • GLIS2 • KMT2A • MLLT3

Near Universal National Uptake of Dexrazoxane in the Real-World Setting Associated with Reduced Cardiac ICU Care Requirements in Pediatric Acute Myeloid Leukemia (ASH 2024) - "For a subset of this cohort, we are actively abstracting individual echocardiogram reports in addition to comprehensive clinical data. Future work will include analyses of dexrazoxane exposure with longitudinal measures of cardiac structure and function from the echocardiograms, durations of neutropenia, infectious complications, as well as event-free and overall survival beyond six months."

Clinical • Real-world • Real-world evidence • Acute Myelogenous Leukemia • Hematological Disorders • Hematological Malignancies • Leukemia • Neutropenia • Oncology • Pediatrics

Current strategies for prevention of cancer therapy-related cardiotoxicity: pharmacological, non-pharmacological and emerging approaches. (PubMed, Front Cardiovasc Med) - "Dexrazoxane is the only FDA-approved agent and shows robust protection in anthracycline-treated patients. Statins and metformin demonstrate promising but still investigational cardioprotective effects, while sodium-glucose cotransporter-2 inhibitors (SGLT2i) show encouraging pilot data...Exercise and nutrition provide functional and quality of life benefits, while several novel strategies remain exploratory. Future large-scale, multicenter, randomized trial are needed to harmonize international guidelines and define the most effective, sustainable prevention models across diverse patient populations."

Journal • Review • Cardiovascular • Oncology

Association of Early Dexrazoxane with Reduced Cardiotoxicity Risk in Sarcoma Patients Treated with Anthracycline Chemotherapy. (PubMed, Oncologist) - "Early dexrazoxane is significantly associated with lower cardiotoxicity risk in adults with sarcoma receiving anthracycline doses >300 mg/m2. These findings support the potential benefit of early dexrazoxane use in patients at elevated risk for anthracycline-induced cardiotoxicity, however further validation is warranted."

Journal • Cardiovascular • Diabetes • Metabolic Disorders • Oncology • Sarcoma • Solid Tumor

Anthracycline- and HER2-induced cardiotoxicity: mechanisms, current strategies, and the emerging role of dapagliflozin as a targeted cardioprotective agent. (PubMed, Cardiooncology) - P2 | "As cancer survival improves, long-term cardiovascular outcomes have become increasingly important, yet current preventive strategies-such as dose reduction, dexrazoxane, neurohormonal blockers, and statins-offer only limited protection and are underutilized in routine clinical practice...Preclinical models have shown that dapagliflozin can preserve left ventricular function, reduce biomarker elevation, and prevent structural remodeling in hearts exposed to doxorubicin. Building on this evidence, a randomized, double-blind, placebo-controlled clinical trial (NCT06888505) is currently underway to evaluate dapagliflozin in cancer patients receiving anthracycline-based chemotherapy, with or without trastuzumab. The study incorporates serial biomarker assessments and cardiac function monitoring to assess its preventive potential.Dapagliflozin represents a promising therapeutic candidate in cardio-oncology. Its pleiotropic cardioprotective effects, oral route of..."

Clinical • Journal • Review • Cardiovascular • Congestive Heart Failure • Diabetes • Fibrosis • Heart Failure • Immunology • Metabolic Disorders • Oncology • Type 2 Diabetes Mellitus • HER-2

Irinotecan and Carboplatin as Upfront Window Therapy in Treating Patients With Newly Diagnosed Intermediate-Risk or High-Risk Rhabdomyosarcoma (clinicaltrials.gov) - P2 | N=65 | Active, not recruiting | Sponsor: Memorial Sloan Kettering Cancer Center | Trial completion date: Oct 2025 ➔ Oct 2026 | Trial primary completion date: Oct 2025 ➔ Oct 2026

Trial completion date • Trial primary completion date • Oncology • Rhabdomyosarcoma • Sarcoma • Solid Tumor

Mutational analysis of the mitochondrial tRNA genes and flanking regions in lymphocytes from long-term pediatric cancer survivors given doxorubicin chemotherapy for acute lymphoblastic leukemia. (PubMed, Cardiooncology) - "The results of this study indicate that doxorubicin chemotherapy is associated with increases in mtDNA sequence variants in lymphocytes. The role of mtDNA mutations in late-onset cardiomyopathy of doxorubicin, and the potential antimutagenic activity of dexrazoxane, were not established but warrant further investigation."

Biomarker • Journal • Acute Lymphocytic Leukemia • Cardiomyopathy • Cardiovascular • Hematological Malignancies • Leukemia • Metabolic Disorders • Oncology • Pediatrics

Longitudinal Echocardiographic Assessment of Subacute Cardiotoxicity in a Prospective Cohort of Adolescents and Young Adults with Sarcoma Treated with High-Dose Doxorubicin (AHA 2025) - "Median cumulative Dox dose was 450 [IQR, 370−450] mg/m2 with 95% of patients receiving >250mg/m2 and 75% receiving dexrazoxane. A significant proportion of AYAs with sarcoma treated with high-dose Dox have worsened LV systolic and diastolic function, as well as strain 1 year post treatment. Beyond LVEF, which has been traditionally used to define cancer therapy related cardiac dysfunction, use of diastolic function and strain may be valuable for risk stratification and diagnosis of subacute Dox-induced myocardial injury. Larger, prospective studies with longer follow up are needed to determine if these early echo abnormalities translate into subsequent cardiomyopathy or heart failure."

Clinical • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Sarcoma • Solid Tumor

Identifying cardioprotective strategies against DOX-induced cardiotoxicity using mature, mitochondrial-rich and patient-derived hiPSC-cardiomyocytes (AHA 2025) - "Introduction: Doxorubicin (DOX) is widely used in cancer treatment but may cause mitochondrial damage and cardiotoxicity. Dexrazoxane is the only clinically approved intervention for DOX-induced cardiotoxicity (DCT); however, it may reduce DOX's anti-cancer effectiveness... Patient-derived CD36hi CMs is critical for the identification of new treatment against DCT. Using this and an in vivo model, we identified candidates that suppress DCT without protecting or even suppress cancer."

Clinical • Cardiovascular • CD36 • SCARB1