Doxorubicin (Streptomyces peucetius)
Carcinoma, sarcoma. Not Ca renal cell, bronchogenic, colonic.
Intercalate DNA, binds iron → generates free radicals,
Does not cross blood-brain barrier, so will not touch CNS mets.
Aesthenia, palmar-plantar erythrodysaesthesia,
myelosuppression (anaemia, neutropaenia,
thrombocytopaenia), mucositis, alopecia.
Risk of dilated cardiomyopathy at high doses, Dexrazoxane
used concommitantly as cardioprotective (not licensed in UK).
Points of interest
Available in liposomal form. MPEG on the surface protects
the liposomes from opsonisation by plasma proteins and subsequent
detection as a foreign molecule by the mononuclear