{"doi":"10.1093/oncolo/oyaf370","title":"Association of early dexrazoxane with reduced cardiotoxicity risk in sarcoma patients treated with anthracycline chemotherapy","abstract":"BACKGROUND: Cardiotoxicity is a concern for patients with sarcoma receiving anthracyclines. Dexrazoxane reduces this risk; however, the timing of administration varies in practice. This study evaluated the association between dexrazoxane timing and anthracycline cardiotoxicity risk. PATIENTS AND METHODS: This retrospective, single-center cohort study included adults with sarcoma treated with anthracyclines from 2010 to 2020 with a baseline and ≥1 follow-up echocardiogram. \"Early\" dexrazoxane was defined as starting with the first anthracycline dose; \"later\" as starting with the second or subsequent doses. The primary endpoint was time to cardiotoxicity (decline in left ventricular ejection fraction [LVEF] ≥10%-<50% from baseline). Associations were evaluated using multivariable Cox proportional hazards models. RESULTS: Among 672 patients, the median doxorubicin-equivalent dose was 300 mg/m2 (interquartile range [IQR]: 200-444 mg/m2); dexrazoxane was administered early in 130 patients (19.3%) and later in 275 (40.9%). Over a median follow-up of 8.6 months (IQR: 3.9-23.1 months), 48 (7.1%) developed cardiotoxicity. Among patients who received a cumulative anthracycline dose >300 mg/m2, those receiving early dexrazoxane had an 85% reduction in cardiotoxicity risk (hazard ratio, 0.15; 95% CI, 0.02-0.99) compared to those who did not receive dexrazoxane, adjusting for age, diabetes, and baseline LVEF. Early dexrazoxane was not significantly associated with cardiotoxicity risk among patients who received a cumulative anthracycline dose ≤300 mg/m2. CONCLUSIONS: Early dexrazoxane is significantly associated with lower cardiotoxicity risk in adults with sarcoma receiving anthracycline doses >300 mg/m2. These findings support the potential benefit of early dexrazoxane use in patients at elevated risk for anthracycline-induced cardiotoxicity; however, further validation is warranted.","journal":"The Oncologist","year":2025,"id":535334,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9244,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1419430,"name":"Joseph S. Wallins","orcid":null,"position":1,"is_corresponding":false},{"id":326597,"name":"I‐Hsin Lin","orcid":"0000-0002-7600-5321","position":2,"is_corresponding":false},{"id":244420,"name":"Sujana Movva","orcid":"0000-0002-6569-6606","position":3,"is_corresponding":false},{"id":245675,"name":"William D. Tap","orcid":"0000-0001-7779-2796","position":4,"is_corresponding":false},{"id":1418927,"name":"Jennifer E Liu","orcid":"0009-0007-1716-1950","position":5,"is_corresponding":false},{"id":497224,"name":"Anthony F. Yu","orcid":"0000-0002-7120-8285","position":6,"is_corresponding":false},{"id":1418926,"name":"Kristine Jang","orcid":"0009-0002-0444-7056","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":null,"created_at":"2026-07-19T02:51:56.297114Z","pmid":"41206057","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}