Epirubicin in breast cancer treatment

Abstract

Epirubicin is a doxorubicin analog that is increasingly used in the management of patients with early and advanced breast cancer. Epirubicin is less cardiotoxic than doxorubicin, thus providing a convenient alternative to the parent compound. Studies in early and advanced breast cancer suggest that these two anthracyclines can be used interchangeably, although the exact dose equivalence between epirubicin and doxorubicin has not been determined. In adjuvant treatment, which aims at cure, studies reported thus far have been unable to establish the most active dose or the best combination containing epirubicin. This article provides an overview of randomized trials and meta-analyses that have attempted to define the role of epirubicin in curative and palliative chemotherapy for patients with breast cancer. Our main question concerns the ideal dose of epirubicin in adjuvant treatment, and we conclude by suggesting the chemotherapy regimen containing epirubicin that we consider most suitable.