How it is administered

Doxorubicin is given as an intravenous (IV) infusion. It is available as a solution or as a powder that is reconstituted and diluted before administration. The medication is infused through a vein, typically over 3 to 10 minutes, or as a longer continuous infusion, depending on the treatment protocol. For liposomal formulations (such as Doxil), it is administered as an IV infusion over 60 minutes.

Doxorubicin should only be given by healthcare professionals experienced in chemotherapy administration, and special care is taken to avoid leakage of the drug outside the vein (extravasation), which can cause tissue damage.

How it works

Doxorubicin is an anthracycline topoisomerase II inhibitor. It works by entering cancer cells and binding to their DNA. This binding interferes with the replication of DNA and the production of RNA, which are essential for cell division and growth. Doxorubicin also interacts with the enzyme topoisomerase II, forming complexes that cause breaks in DNA strands. These actions ultimately lead to the death of rapidly dividing cancer cells.

In addition, doxorubicin can generate free radicals, which may contribute to its ability to kill cancer cells but also to some of its side effects, such as heart damage. Because it targets rapidly dividing cells, it is effective against many types of blood cancers, including Burkitt Lymphoma.

Who Should take it

Doxorubicin is used as part of combination chemotherapy regimens for various cancers, including blood cancers like Burkitt Lymphoma, non-Hodgkin lymphoma, Hodgkin lymphoma, and certain leukemias. It is also used for solid tumors such as breast cancer, ovarian cancer, and others.

For Burkitt Lymphoma, doxorubicin is often included in intensive multi-drug chemotherapy protocols. The decision to use doxorubicin is based on the type and stage of cancer, as well as the patient's overall health and ability to tolerate chemotherapy.

Who should not take it

Doxorubicin should not be taken by patients with:

• Severe heart problems or recent heart attack
• Severe, persistent low blood cell counts due to previous chemotherapy
• Severe liver impairment (Child-Pugh Class C or serum bilirubin >5 mg/dL)
• Known hypersensitivity or allergic reaction to doxorubicin or its components

It should also be avoided during the first trimester of pregnancy due to the risk of harm to the unborn baby. Patients with a history of previous high cumulative doses of doxorubicin or other anthracyclines should discuss the risks with their doctor, as the risk of heart damage increases with higher lifetime exposure.

Commonly used with

Doxorubicin is most often used in combination with other chemotherapy drugs. In the treatment of Burkitt Lymphoma and other blood cancers, it may be combined with cyclophosphamide, vincristine, prednisone, methotrexate, cytarabine, and others. The exact combination depends on the specific treatment protocol and the patient's needs.

Commonly tested with

Doxorubicin has been tested in combination with other chemotherapy agents such as cyclophosphamide, vincristine, methotrexate, cytarabine, and prednisone, especially in regimens for lymphomas and leukemias. It is also tested with supportive medications to reduce side effects, such as dexrazoxane (to reduce heart damage) and anti-nausea medications.