Epirubicin Health Article

Definition

Epirubicin is a semi-synthetic anthracycline-based anticancer (or antineoplastic) drug derived from doxorubicin. It is also known by its trade name Ellence.

Purpose

Epirubicin is used as the chemotherapy agent for adjuvant therapy in patients diagnosed with breast cancer, and, as determined by the attending oncologist, epirubicin may be used in the treatment of lung, gastric, and pancreatic cancers.

Description

It has been used extensively since the mid-1980s for both early stage and metastatic breast cancer. Epirubicin received Federal Drug Administration approval in the fall of 1999 for adjuvant therapy in patients with node-positive breast cancer. Like other DNA-interactive antineoplastic family members, epirubicin binds to DNA to inhibit DNA, RNA, and protein synthesis resulting in cell death. It has been demonstrated that epirubicin also acts to block cell growth and to increase the production of cytotoxic free radicals. For breast cancer treatment, epirubicin has proved a highly effective chemotherapy agent when administered as a single agent in a sequential regimen. Epirubicin may be given in combination with cyclophosphamide, and 5-fluo-rouracil; however, currently there is no clinical evidence to suggest that long-term survival is greater in the combination regimen than with epirubicin alone. Indeed, the lower toxicity associated with epirubicin treatment promotes better quality of life for the patient.

Recommended dosage

Epirubicin is administered as a red fluid via intravenous injection (IV) into a cannula placed into the vein or through a central line inserted under the skin into a vein near the collarbone. The dose of epirubicin prescribed will vary among patients, correlated with patient body size, the purpose of the dose, whether the epirubicin will be used as a single agent or in combination, and the stage and aggressiveness of the cancer type. A starting dose of 50 mg/m² of body surface per dose cycle of epirubicin is an appropriate regimen. Treatment cycles may be given weekly, or with higher doses, cycles may be reduced to only two to three times per month. The maximum cumulative dose for anthracyclines is defined by cardiotoxicity. Studies on epirubicin have only been conducted on adult patients; therefore, with the associated risk of cardiotoxicity there are no recommendations for dosage on young children or the elderly.