Cochrane · systematic review · CD014638
Dexrazoxane for preventing or reducing cardiotoxicity in adults and children with cancer receiving anthracyclines
de Baat, EC, Mulder, RL, Armenian, S, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
20
current version
GRADE rated
16
No studies
4
Included studies
NR
No studies 4 · 20%Ungraded 0 · 0%Very low 2 · 10%Low 8 · 40%Moderate 6 · 30%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Dexrazoxane versus no cardioprotective intervention or placebo for preventing or reducing cardiotoxicity in adults with cancer receiving anthracyclines
Population: adults with cancer receiving anthracyclines
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical heart failure Available case analysis Dexrazoxane vs no cardioprotective intervention or placebo | RR 0.22 [0.11, 0.43] | 7 studies · 1221 participants | Moderate Downgraded: risk of bias, imprecision |
Clinical heart failure and subclinical myocardial dysfunction combined Comparable definitions; see Characteristics of included studies for exact definitions. Available‐case analysis Dexrazoxane vs no cardioprotective intervention or placebo | RR 0.37 [0.24, 0.56] | 3 studies · 417 participants | Moderate Downgraded: risk of bias, imprecision |
Clinical heart failure and subclinical myocardial dysfunction combined Comparable definitions; see Characteristics of included studies for exact definitions. Available‐case analysis Dexrazoxane vs no cardioprotective intervention or placebo | RR 0.46 [0.33, 0.66] | 2 studies · 534 participants | Moderate Downgraded: risk of bias, imprecision |
Overall survival (Illustrative comparative risks reported as number of alive participants) Dexrazoxane vs no cardioprotective intervention or placebo | HR 1.04 [0.88, 1.23] | 4 studies · 4 participants | Moderate Downgraded: risk of bias, imprecision |
Progression‐free survival Defined as time from first date of complete response, partial response or stable disease until the date progressive disease was first noticed (Illustrative comparative risks reported as number of participants without prog... Dexrazoxane vs no cardioprotective intervention or placebo | HR 0.62 [0.43, 0.9] | 1 study · 164 participants | Low Downgraded: risk of bias, imprecision |
Progression‐free survival Defined as time to progression; starting point nm (Illustrative comparative risks reported as number of participants without progression) Dexrazoxane vs no cardioprotective intervention or placebo | HR 0.95 [0.64, 1.4] | 1 study · 1 participants | Low Downgraded: risk of bias, imprecision |
Progression‐free survival Defined as time from randomisation to progression either on or off treatment (Illustrative comparative risks reported as number of participants without progression) Dexrazoxane vs no cardioprotective intervention or placebo | HR 1.18 [0.97, 1.43] | 2 studies · 2 participants | Moderate Downgraded: risk of bias, imprecision |
Tumour response rate Defined as number of complete or partial remissions Available‐case analysis Dexrazoxane vs no cardioprotective intervention or placebo | RR 0.91 [0.79, 1.04] | 6 studies · 956 participants | Moderate Downgraded: risk of bias, imprecision |
Quality of life Dexrazoxane vs no cardioprotective intervention or placebo | no estimate extracted | NR | No studies |
Secondary malignant neoplasms Dexrazoxane vs no cardioprotective intervention or placebo | no estimate extracted | NR | No studies |
Dexrazoxane versus no cardioprotective intervention for preventing or reducing cardiotoxicity in children with cancer receiving anthracyclines
Population: children with cancer receiving anthracyclines
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Clinical heart failure Available‐case analysis Dexrazoxane vs no cardioprotective intervention | RR 0.2 [0.01, 4.19] | 3 studies · 885 participants | Low Downgraded: risk of bias, imprecision |
Cardiomyopathy/heart failure primary cause of death Available‐case analysis Dexrazoxane vs no cardioprotective intervention | no estimate extracted | 3 studies · 1008 participants | Low Downgraded: risk of bias, imprecision |
Clinical heart failure and subclinical myocardial dysfunction combined Defined as (1) evidence of clinical congestive heart failure, (2) a reduction in LVEF as measured by MUGA to < 45% or (3) a decrease in LVEF as measured by MUGA of > 20 percent... Dexrazoxane vs no cardioprotective intervention | RR 0.33 [0.13, 0.85] | 1 study · 33 participants | Low Downgraded: risk of bias, imprecision |
Clinical heart failure and subclinical myocardial dysfunction combined Defined as clinical heart failure (no definition provided) or subclinical myocardial dysfunction defined as decreased LVFS; however, it was stated that toxicity was graded acco... Dexrazoxane vs no cardioprotective intervention | no estimate extracted | 1 study · 537 participants | Very low Downgraded: risk of bias, imprecision |
Overall mortality (Reported as number of participants who died) Dexrazoxane vs no cardioprotective intervention | HR 1.01 [0.72, 1.42] | 3 studies · 1008 participants | Low Downgraded: risk of bias, imprecision |
Progression‐free survival Dexrazoxane vs no cardioprotective intervention | no estimate extracted | NR | No studies |
Tumour response rate Defined as number of complete remissions (no definition of complete remission provided). Best‐case analysis Dexrazoxane vs no cardioprotective intervention | RR 1.01 [0.95, 1.07] | 1 study · 206 participants | Very low Downgraded: risk of bias, imprecision |
Tumour response rate Defined as number of complete responses (i.e. disappearance of active Hodgkin lymphoma (gallium negative, ≥ 70% decrease in the sum of the products of the perpendicular diameters of measurable lesions, and negative bone marrow... Dexrazoxane vs no cardioprotective intervention | RR 0.92 [0.84, 1.01] | 1 study · 200 participants | Low Downgraded: risk of bias, imprecision |
Quality of life Dexrazoxane vs no cardioprotective intervention | no estimate extracted | NR | No studies |
Secondary malignant neoplasms Available‐case analysis Dexrazoxane vs no cardioprotective intervention | RR 3.08 [1.13, 8.38] | 3 studies · 1015 participants | Low Downgraded: risk of bias, imprecision |