Anthracyclines are one of the most effective treatments for various types of cancer. Unfortunately, there is a risk of heart damage depending on the total dose a patient has received. In an effort to prevent this heart damage different anthracycline dosage schedules (like different infusion durations or different individual peak doses) are being used.
Based on the currently available evidence, the authors are not able to favour either a doxorubicin peak dose of less than 60 mg/m2 or 60 mg/m2 or more. For the use of other anthracycline peak doses there was not enough high quality evidence available to draw conclusions. For children and individuals with leukaemia no data are available. For the use of different anthracycline infusion durations, the authors found that an anthracycline infusion duration of six hours or longer reduces the risk of clinical heart failure (i.e. patients have symptoms like shortness of breath or oedema in the legs), and it seems to reduce the risk of subclinical heart failure (i.e. heart damage diagnosed with for example echocardiography in patients without symptoms). There is only a small amount of data available for children and individuals with leukaemia; most studies evaluating different anthracycline infusion durations were performed in adults with solid tumours. Further high quality research is needed.