What is Doxorubicin?
Doxorubicin—also known by its brand names Adriamycin and Doxil—is the oldest FDA approved chemotherapy drug in the United States. Doctors commonly use it to treat cancers such as non-Hodgkin’s lymphoma, breast cancer, and various myelomas. They’ve also extensively researched its effectiveness as a treatment for mesothelioma, most often combining it with other drugs.
Doxorubicin is an anthracycline, a class of drugs researchers developed from streptomyces, a fungus that grows naturally in soil. It slows the metastasis of mesothelioma by blocking a cancer cell’s ability to replicate DNA. Without enough DNA, which they need for new cells, cancer cells in a mesothelioma tumor die—and the tumor itself shrinks.
Because of its tumor shrinking ability, doctors use doxorubicin as a palliative treatmentto help patients with advanced mesothelioma improve their quality of life. Palliative treatments like doxorubicin stop the growth of mesothelioma, reducing the symptoms caused by large tumors.
Doxorubicin in Clinical Trials
In a recent study carried out in Belgium, researchers combined doxorubicin and valproate, a drug normally used for epilepsy, to treat patients diagnosed with mesothelioma. The combination of drugs produced a median survival time of 17 months.
Researchers have also shown that doxorubicin works well as a treatment for patients with advanced stage mesothelioma that doctors can’t remove with surgery. They combined it with cisplatin, a platinum based drug, and improved the survival rate of patients with advanced mesothelioma by 23 months—twice the average life expectancy associated with mesothelioma.
How Doctors Give It
Before treatment begins, doctors give their patient an anti-nausea drug to help reduce any side effects caused by doxorubicin. They’ll also have a nurse perform a blood test, which the doctor uses to monitor changes in the patient’s blood cell count.
Doctors give doxorubicin through an IV. Each treatment cycle typically lasts 15 to 30 minutes, and the number of cycles depends on the patient’s overall health; the healthier he or she is, the more doxorubicin they’ll be able to withstand.
Patients diagnosed with either pleural or peritoneal mesothelioma can also receive the drug during an operation. Intraoperative doxorubicin helps shrink mesothelioma tumors while doctors perform surgery.
Doxorubicin causes side effects similar to those produced by other chemotherapy drugs. Like other drugs, it targets cancer cells, which divide and spread quickly. Doxorubicin can’t, however, tell the difference between cancer cells and healthy cells that also divide rapidly, like hair cells. When the drug kills healthy cells—as “collateral damage”—side effects occur.
The most common side effects caused by doxorubicin include:
Doxorubicin can also interfere with the heart’s pumping function. While this side effect is uncommon, it’s serious, and the reason why patients can only receive a maximum amount of doxorubicin during a lifetime. Doctors consider a number of factors—the patient’s age, history of heart disease, and use of other heart-toxic drugs—to determine the maximum amount of doxurubicin they’ll give during treatment.
Is It Right for You?
If you’re considering adding doxorubicin, or any other chemotherapy, to your treatment regimen, make sure you speak to a doctor who has experience treating mesothelioma first. Like any chemotherapy, the effectiveness of doxorubicin depends on your diagnosis—the location, cancer stage, and cell type of the mesothelioma—and overall health.