Evidence map›Paper›PMID 34396164›Full record

ArticleJACC. CardioOncology2019

Efficacy of Dexrazoxane in Preventing Anthracycline Cardiotoxicity in Breast Cancer.

Ariane V S Macedo, Ludhmila A Hajjar, Alexander R Lyon, Bruno R Nascimento, Alessandro Putzu, Lorenzo Rossi, Rafael B Costa, Giovanni Landoni, Angélica Nogueira-Rodrigues, Antonio L P Ribeiro

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. CardioOncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 105 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
105citing papers in PubMed, 5 pooled it
6.9field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

105 citing papers in PubMed, 5 syntheses or guidelines pooled it, 159 citations in OpenAlex.

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  20. Caught in the crossfire: cardiac complications of cancer therapy.The Journal of clinical investigation · 2026
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45 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 6 institutions in 4 countries.

Ariane V S MacedoDepartment of Cardiology of Hospital das Clínicas, Federal University of Minas Gerais and Department of Internal Medicine, School of Medicine of Federal University of Minas Gerais, Belo Horizonte, Brazil.
Ludhmila A HajjarDepartment of Cardiopneumology of InCor and Division of Cardio-Oncology, Cancer Institute of Sao Paulo, School of Medicine of São Paulo University, São Paulo, Brazil.
Alexander R LyonCardio-oncology Service, Royal Brompton Hospital and Imperial College London, United Kingdom.
Bruno R NascimentoDepartment of Cardiology of Hospital das Clínicas, Federal University of Minas Gerais and Department of Internal Medicine, School of Medicine of Federal University of Minas Gerais, Belo Horizonte, Brazil.
Alessandro PutzuDivision of Anesthesiology, Department of Anesthesiology, Pharmacology, Intensive Care, and Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland.
Lorenzo RossiInstitute of Oncology of Southern Switzerland, Bellinzona, Switzerland.
Rafael B CostaOncoclínicas Group, Belo Horizonte, Brazil.
Giovanni LandoniDepartment of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Angélica Nogueira-RodriguesDivision of Oncology of Hospital das Clínicas, Federal University of Minas Gerais and Department of Internal Medicine, School of Medicine of Federal University of Minas Gerais, Belo Horizonte, Brazil.
Antonio L P RibeiroDepartment of Cardiology of Hospital das Clínicas, Federal University of Minas Gerais and Department of Internal Medicine, School of Medicine of Federal University of Minas Gerais, Belo Horizonte, Brazil.
Universidade Federal de Minas Gerais · BRHospital das Clínicas da Universidade Federal de Minas Gerais · BRInstitute of Oncology Research · CHIstituto di Ricovero e Cura a Carattere Scientifico San RaffaeleRoyal Brompton Hospital · GBUniversity Hospital of Geneva · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe authors performed a systematic review and meta-analysis of randomized and nonrandomized trials on the efficacy of dexrazoxane in patients with breast cancer who were treated with anthracyclines with or without trastuzumab.

backgroundBreast cancer treatment with anthracyclines and trastuzumab is associated with an increased risk of cardiotoxicity. Among the various strategies to reduce the risk of cardiotoxicity, dexrazoxane is an option for primary prevention, but it is seldom used in clinical practice.

methodsOnline databases were searched from January 1990 up to March 1, 2019, for clinical trials on the use of dexrazoxane for the prevention of cardiotoxicity in patients with breast cancer receiving anthracyclines with or without trastuzumab. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model meta-analysis.

resultsSeven randomized trials and 2 retrospective trials with a total of 2,177 patients were included. Dexrazoxane reduced the risk of clinical heart failure (RR: 0.19; 95% CI: 0.09 to 0.40; p < 0.001) and cardiac events (RR: 0.36; 95% CI: 0.27 to 0.49; p < 0.001) irrespective of previous exposure to anthracyclines. The rate of a partial or complete oncological response, overall survival, and progression-free survival were not affected by dexrazoxane.

conclusionsDexrazoxane reduced the risk of clinical heart failure and cardiac events in patients with breast cancer undergoing anthracycline chemotherapy with or without trastuzumab and did not significantly impact cancer outcomes. However, the quality of available evidence is low, and further randomized trials are warranted before the systematic implementation of this therapy in clinical practice.

Indexed as

ANT, anthracyclineBC, breast cancercardiomyopathycardioprotectioncardiotoxicityCI, confidence intervalCTX, cardiotoxicityDEX, dexrazoxanedexrazoxanedoxorubicinheart failureHER2, anti–human epidermal growth factor 2HR, hazard ratiometa-analysisRR, risk ratiosurvivorshiptrastuzumab

Identifiers

PMID34396164
PMCPMC8352186
OpenAlexW2976106895

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.