Adriamycin (CAS: 23214-92-8)

Doxorubicin /ˌdɒksəˈruːbəsɪn/ (INN, AAN, BAN, USAN; trade name Adriamycin;

liposome-encapsulated trade name Doxil), also known ashydroxydaunorubicin, is a drug

 used in cancer chemotherapy and derived by chemical semisynthesis from a bacterial

species. It is ananthracycline antibiotic (note: in this context, this does not mean it is used

to treat bacterial infections) closely related to the natural product daunomycin and like all

anthracyclines, it works by intercalating DNA, with the most serious adverse effect being

life-threatening heart damage. It is commonly used in the treatment of a wide range of cancers,

including hematological malignancies (blood cancers, like leukaemia andlymphoma), many

types of carcinoma (solid tumours) and soft tissue sarcomas.

Common adverse effects of doxorubicin include hair loss (seen in most of those treated with

the drug), myelosuppression (a compromised ability of the body’s bone marrow to produce

new blood cells), nausea and vomiting (which are seen in roughly 30-90% of people treated

with the drug), oral mucositis, oesophagitis, diarrhoea, skin reactions (including hand-foot

syndrome) and localised swelling and redness along the vein in which the drug is delivered.

Less common, yet serious reactions include hypersensitivity reactions (including anaphylaxis),

 radiation recall, heart damage and liver dysfunction.

The drug is administered intravenously, as the hydrochloride salt. It is sold under a number of

different brand names, including Adriamycin PFS, Adriamycin RDF, or Rubex. Doxorubicin is

photosensitive, and containers are often covered by an aluminum bag and/or brown wax paper

to prevent light from affecting it. Doxorubicin is also available in liposome-encapsulated forms

(that is, pegylated forms) as Doxil (United States), Caelyx and Myocet, although these forms

must also be given by intravenous injection.

Medical use

Doxorubicin is commonly used to treat some leukemias and Hodgkin’s lymphoma, as well as

cancers of the bladder, breast, stomach, lung, ovaries,thyroid, soft tissue sarcoma, multiple

myeloma, and others. Commonly used doxorubicin-containing regimens are AC (Adriamycin,

cyclophosphamide), TAC (Taxotere, AC), ABVD (Adriamycin, bleomycin, vinblastine, 

dacarbazine), BEACOPP, CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, 

prednisone) and FAC (5-fluorouracil, Adriamycin, cyclophosphamide).

Doxil (see below) is used primarily for the treatment of ovarian cancer where the disease

has progressed or recurred after platinum-based chemotherapy, or for the treatment of 

AIDS-related Kaposi’s sarcoma.