Common brand names

• Adriamycin
• Doxil

How it is administered

Doxorubicin is given as an intravenous (IV) infusion, meaning it is administered directly into a vein. It comes in different forms, including a standard solution and a liposomal formulation (which is encapsulated in tiny fat-like particles for slower release). The medication is provided in vials and is diluted before being infused, usually over a period of 3 to 60 minutes, depending on the specific product and protocol. It is never given as a quick injection or by mouth.

How it works

Doxorubicin is a type of chemotherapy drug known as an anthracycline topoisomerase inhibitor. It works by entering cancer cells and binding to their DNA. This binding disrupts the normal function of DNA and RNA, which are essential for cell growth and division. Doxorubicin also interferes with an enzyme called topoisomerase II, which helps manage the structure of DNA during cell division. By blocking this enzyme, doxorubicin causes breaks in the DNA, leading to cell death.

Because it targets rapidly dividing cells, doxorubicin is effective against many types of cancer, including various blood cancers. However, it can also affect healthy cells that divide quickly, which is why side effects can occur.

Who should take it

Doxorubicin is used as part of combination chemotherapy regimens for several cancers, including acute lymphoblastic leukemia (ALL), which is closely related to lymphoblastic lymphoma, as well as other blood cancers like acute myeloblastic leukemia, Hodgkin lymphoma, and non-Hodgkin lymphoma. It is also used for solid tumors such as breast cancer, ovarian cancer, and others.

For lymphoblastic lymphoma and related blood cancers, doxorubicin is often included in multi-drug protocols to help destroy cancerous lymphocytes. Your doctor will determine if doxorubicin is appropriate for your specific diagnosis and treatment plan.

Who should not take it

Doxorubicin should not be used in patients with:

• Severe heart problems (such as severe myocardial insufficiency or recent heart attack)
• Severe ongoing suppression of bone marrow function (myelosuppression)
• Severe liver impairment (Child-Pugh Class C or very high bilirubin levels)
• A history of severe allergic reaction to doxorubicin or its components

If you have any of these conditions, your doctor will consider alternative treatments. Doxorubicin should also be avoided during pregnancy, especially in the first trimester, due to the risk of harm to the unborn baby.

Commonly used with

Doxorubicin is most often used in combination with other chemotherapy drugs. For blood cancers like lymphoblastic lymphoma, it may be combined with medications such as cyclophosphamide, vincristine, prednisone, methotrexate, and others. The exact combination depends on your specific diagnosis and treatment protocol.

It is also sometimes given with medications to help protect the heart or reduce side effects, such as dexrazoxane in certain cases.

Commonly tested with

Doxorubicin is frequently tested in combination with other chemotherapy agents in clinical trials for blood cancers and lymphomas. Common partners in these studies include cyclophosphamide, vincristine, prednisone, methotrexate, and cytarabine. It is also studied with newer targeted therapies and supportive care medications to improve outcomes and reduce side effects.