Aclarubicin: preclinical and clinical data suggesting less chronic cardiotoxicity compared with conventional anthracyclines.

SUMMARY A survey of the adverse cardiovascular reactions elicited by treatment with the new anthracycline derivative aclarubicin is presented based on the results from selected animal experiments and available clinical data. With doxorubicin as a reference experimental studies have shown that cardiotoxicity from aclarubicin is more than ten-fold lower, regarding both acute and chronic damage. It is premature to draw definite conclusions regarding the entire cardiotoxic profile in humans. ECG-manifestations in the early treatment period with prolongation of the QTc-interval may signal risk of severe ventricular arrhythmias in rare cases. The trend when reviewing the phase I-II trials with aclarubicin in acute leukaemia seems to be low incidence of chronic cardiotoxicity in spite of prior daunorubicin therapy — even in considerable doses. Thus, published clinical data stimulate the pursuance of randomized phase III trials comparing aclarubicin to conventional anthracyclines to substantiate the supposed improved therapeutic index of this new derivative.