Doxorubicin (Streptomyces peucetius)


Carcinoma, sarcoma. Not Ca renal cell, bronchogenic, colonic.


Intercalate DNA, binds iron → generates free radicals, peroxidises lipids.
Does not cross blood-brain barrier, so will not touch CNS mets.

Adverse effects

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 phagocyte system.