Epirubicin is an anthracycline cytotoxic agent, is a 4'-epi-isomer of doxorubicin. The compound is marketed by Pfizer under the trade name Ellence in the US. It is indicated as a component of adjuvant therapy in patients with evidence of axillary node tumor involvement following resection of primary breast cancer. Although it is known that anthracyclines can interfere with a number of biochemical and biological functions within eukaryotic cells, the precise mechanisms of epirubicin’s cytotoxic and/or antiproliferative properties have not been completely elucidated. It is known, that epirubicin forms a complex with DNA by intercalation of its planar rings between nucleotide base pairs, with consequent inhibition of nucleic acid (DNA and RNA) and protein synthesis. Such intercalation triggers DNA cleavage by topoisomerase II, resulting in cytocidal activity. Epirubicin also inhibits DNA helicase activity, preventing the enzymatic separation of double-stranded DNA and interfering with replication and transcription. Epirubicin is also involved in oxidation/reduction reactions by generating cytotoxic free radicals.
CNS Activity
Originator
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
Target ID: CHEMBL2311221 |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | ELLENCE Approved UseEpirubicin Hydrochloride Injection is indicated as a component of adjuvant therapy in patients with evidence of axillary node tumor involvement following resection of primary breast cancer Launch Date1999 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
5.7 μg/mL |
60 mg/m² single, intravenous dose: 60 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
EPIRUBICIN plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
9.3 μg/mL |
150 mg/m² single, intravenous dose: 150 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
EPIRUBICIN plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
AUC
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
1.6 μg × h/mL |
60 mg/m² single, intravenous dose: 60 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
EPIRUBICIN plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
4.2 μg × h/mL |
150 mg/m² single, intravenous dose: 150 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
EPIRUBICIN plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
T1/2
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
35.3 h |
60 mg/m² single, intravenous dose: 60 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
EPIRUBICIN plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
|
31.1 h |
150 mg/m² single, intravenous dose: 150 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
EPIRUBICIN plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Funbound
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
23% |
60 mg/m² single, intravenous dose: 60 mg/m² route of administration: Intravenous experiment type: SINGLE co-administered: |
EPIRUBICIN plasma | Homo sapiens population: UNHEALTHY age: ADULT sex: FEMALE / MALE food status: UNKNOWN |
Doses
| Dose | Population | Adverse events |
|---|---|---|
200 mg/m2 1 times / 3 weeks multiple, intravenous MTD Dose: 200 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 200 mg/m2, 1 times / 3 weeks Sources: |
unhealthy, 31–62 |
DLT: Thrombocytopenia, Leukopenia... Dose limiting toxicities: Thrombocytopenia (grade 4, 67%) Sources: Leukopenia (grade 4, 67%) Myelosuppression (grade 4, 100%) Stomatitis (grade 3, 33%) |
95 mg/m2 1 times / day multiple, intravenous Overdose Dose: 95 mg/m2, 1 times / day Route: intravenous Route: multiple Dose: 95 mg/m2, 1 times / day Sources: |
unhealthy, 36 Health Status: unhealthy Age Group: 36 Sex: M Sources: |
Disc. AE: Aplasia bone marrow, Mucositis... AEs leading to discontinuation/dose reduction: Aplasia bone marrow Sources: Mucositis (grade 4) Gastrointestinal bleeding |
320 mg/m2 single, intravenous Overdose Dose: 320 mg/m2 Route: intravenous Route: single Dose: 320 mg/m2 Sources: |
unhealthy, 63 Health Status: unhealthy Age Group: 63 Sex: F Sources: |
Disc. AE: Hyperthermia, Multiple organ failure... AEs leading to discontinuation/dose reduction: Hyperthermia Sources: Multiple organ failure Lactic acidosis Lactate dehydrogenase increased Anuria |
120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
Disc. AE: Soft tissue necrosis... AEs leading to discontinuation/dose reduction: Soft tissue necrosis (severe) Sources: |
120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
DLT: Leukopenia, Neutropenia... Disc. AE: Toxic myocarditis, Congestive heart failure... Dose limiting toxicities: Leukopenia AEs leading toNeutropenia discontinuation/dose reduction: Toxic myocarditis (severe) Sources: Congestive heart failure (grade 3-5) Acute promyelocytic leukemia Myelosuppression (severe) Hyperuricemia Thrombophlebitis Thromboembolic event Pulmonary embolism |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| Stomatitis | grade 3, 33% DLT, Disc. AE |
200 mg/m2 1 times / 3 weeks multiple, intravenous MTD Dose: 200 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 200 mg/m2, 1 times / 3 weeks Sources: |
unhealthy, 31–62 |
| Myelosuppression | grade 4, 100% DLT, Disc. AE |
200 mg/m2 1 times / 3 weeks multiple, intravenous MTD Dose: 200 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 200 mg/m2, 1 times / 3 weeks Sources: |
unhealthy, 31–62 |
| Leukopenia | grade 4, 67% DLT, Disc. AE |
200 mg/m2 1 times / 3 weeks multiple, intravenous MTD Dose: 200 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 200 mg/m2, 1 times / 3 weeks Sources: |
unhealthy, 31–62 |
| Thrombocytopenia | grade 4, 67% DLT, Disc. AE |
200 mg/m2 1 times / 3 weeks multiple, intravenous MTD Dose: 200 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 200 mg/m2, 1 times / 3 weeks Sources: |
unhealthy, 31–62 |
| Aplasia bone marrow | Disc. AE | 95 mg/m2 1 times / day multiple, intravenous Overdose Dose: 95 mg/m2, 1 times / day Route: intravenous Route: multiple Dose: 95 mg/m2, 1 times / day Sources: |
unhealthy, 36 Health Status: unhealthy Age Group: 36 Sex: M Sources: |
| Gastrointestinal bleeding | Disc. AE | 95 mg/m2 1 times / day multiple, intravenous Overdose Dose: 95 mg/m2, 1 times / day Route: intravenous Route: multiple Dose: 95 mg/m2, 1 times / day Sources: |
unhealthy, 36 Health Status: unhealthy Age Group: 36 Sex: M Sources: |
| Mucositis | grade 4 Disc. AE |
95 mg/m2 1 times / day multiple, intravenous Overdose Dose: 95 mg/m2, 1 times / day Route: intravenous Route: multiple Dose: 95 mg/m2, 1 times / day Sources: |
unhealthy, 36 Health Status: unhealthy Age Group: 36 Sex: M Sources: |
| Anuria | Disc. AE | 320 mg/m2 single, intravenous Overdose Dose: 320 mg/m2 Route: intravenous Route: single Dose: 320 mg/m2 Sources: |
unhealthy, 63 Health Status: unhealthy Age Group: 63 Sex: F Sources: |
| Hyperthermia | Disc. AE | 320 mg/m2 single, intravenous Overdose Dose: 320 mg/m2 Route: intravenous Route: single Dose: 320 mg/m2 Sources: |
unhealthy, 63 Health Status: unhealthy Age Group: 63 Sex: F Sources: |
| Lactate dehydrogenase increased | Disc. AE | 320 mg/m2 single, intravenous Overdose Dose: 320 mg/m2 Route: intravenous Route: single Dose: 320 mg/m2 Sources: |
unhealthy, 63 Health Status: unhealthy Age Group: 63 Sex: F Sources: |
| Lactic acidosis | Disc. AE | 320 mg/m2 single, intravenous Overdose Dose: 320 mg/m2 Route: intravenous Route: single Dose: 320 mg/m2 Sources: |
unhealthy, 63 Health Status: unhealthy Age Group: 63 Sex: F Sources: |
| Multiple organ failure | Disc. AE | 320 mg/m2 single, intravenous Overdose Dose: 320 mg/m2 Route: intravenous Route: single Dose: 320 mg/m2 Sources: |
unhealthy, 63 Health Status: unhealthy Age Group: 63 Sex: F Sources: |
| Soft tissue necrosis | severe Disc. AE |
120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
| Leukopenia | DLT, Disc. AE | 120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
| Neutropenia | DLT, Disc. AE | 120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
| Acute promyelocytic leukemia | Disc. AE | 120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
| Hyperuricemia | Disc. AE | 120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
| Pulmonary embolism | Disc. AE | 120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
| Thromboembolic event | Disc. AE | 120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
| Thrombophlebitis | Disc. AE | 120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
| Congestive heart failure | grade 3-5 Disc. AE |
120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
| Myelosuppression | severe Disc. AE |
120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
| Toxic myocarditis | severe Disc. AE |
120 mg/m2 1 times / 3 weeks multiple, intravenous Recommended Dose: 120 mg/m2, 1 times / 3 weeks Route: intravenous Route: multiple Dose: 120 mg/m2, 1 times / 3 weeks Sources: |
unhealthy Health Status: unhealthy Sources: |
PubMed
| Title | Date | PubMed |
|---|---|---|
| Activation of caspase-3 in renal cell carcinoma cells by anthracyclines or 5-fluorouracil. | 2001-07 |
|
| Phase III trial comparing two dose levels of epirubicin combined with cyclophosphamide with cyclophosphamide, methotrexate, and fluorouracil in node-positive breast cancer. | 2001-06-15 |
|
| Docetaxel and epirubicin plus G-CSF as mobilizing treatment to support high-dose chemotherapy in breast cancer. | 2001-06-09 |
|
| Chemotherapy response of breast cancer depends on HER-2 status and anthracycline dose intensity in the neoadjuvant setting. | 2001-06 |
|
| Phase II study of epirubicin, mitomycin C, and 5-fluorouracil in hormone-refractory prostatic carcinoma. | 2001-06 |
|
| Results of a phase III prospective, randomised trial, comparing mitoxantrone and vinorelbine (MV) in combination with standard FAC/FEC in front-line therapy of metastatic breast cancer. | 2001-06 |
|
| Importance of surgery as salvage treatment after high dose chemotherapy failure in germ cell tumors. | 2001-06 |
|
| Prophylactic chemolipiodolization for postoperative hepatoma patients. | 2001-05-31 |
|
| [Docetaxel (Taxotere) in combination with anthracycline, capecitabin (Xeloda) and new drugs]. | 2001-05-19 |
|
| Telomere length in breast cancer patients before and after chemotherapy with or without stem cell transplantation. | 2001-05-18 |
|
| Standard chemotherapy for gastric carcinoma: is it a myth? | 2001-05-15 |
|
| Prospective evaluation of early cardiac damage induced by epirubicin-containing adjuvant chemotherapy and locoregional radiotherapy in breast cancer patients. | 2001-05-15 |
|
| Definitive results of a phase II trial of cisplatin, epirubicin, continuous-infusion fluorouracil, and gemcitabine in stage IV pancreatic adenocarcinoma. | 2001-05-15 |
|
| Neoadjuvant high dose chemotherapy plus peripheral blood progenitor cells in inflammatory breast cancer: a multicenter phase II pilot study. | 2001-05 |
|
| Optimizing adjuvant breast cancer chemotherapy: rationale for the MA.21 study. | 2001-05 |
|
| New combinations with epirubicin in advanced breast cancer. | 2001-05 |
|
| Epirubicin/taxane combinations in breast cancer: experience from several Italian trials. | 2001-05 |
|
| Dose-dense and sequential strategies in adjuvant breast cancer therapy. | 2001-05 |
|
| Body surface area as a determinant of pharmacokinetics and drug dosing. | 2001-05 |
|
| Neoadjuvant chemotherapy for Chinese women with locally advanced breast cancer. | 2001-05 |
|
| Management of extravasation injuries. | 2001-05 |
|
| Kinetics of PBPC mobilization by cyclophosphamide, as compared with that by epirubicin/paclitaxel followed by G-CSF support: implications for optimal timing of PBPC harvest. | 2001-05 |
|
| Peripheral blood progenitor cell collection after epirubicin, paclitaxel, and cisplatin combination chemotherapy using EPO-based cytokine regimens: a randomized comparison of G-CSF and sequential GM-/G-CSF. | 2001-05 |
|
| The multimodality treatment of thymic carcinoma. | 2001-05 |
|
| Analysis of treatment failures and survival of patients with fallopian tube carcinoma: a cooperation task force (CTF) study. | 2001-05 |
|
| Epirubicin glucuronidation is catalyzed by human UDP-glucuronosyltransferase 2B7. | 2001-05 |
|
| Dose-dense sequential chemotherapy with epirubicin and paclitaxel versus the combination, as first-line chemotherapy, in advanced breast cancer: a randomized study conducted by the Hellenic Cooperative Oncology Group. | 2001-04-15 |
|
| Clinical and pharmacologic study of the epirubicin and paclitaxel combination in women with metastatic breast cancer. | 2001-04-15 |
|
| Accelerated-intensified cyclophosphamide, epirubicin, and fluorouracil (CEF) compared with standard CEF in metastatic breast cancer patients: results of a multicenter, randomized phase III study of the Italian Gruppo Oncologico Nord-Ouest-Mammella Inter Gruppo Group. | 2001-04-15 |
|
| Multimodality therapy for patients with clinical Stage I and II malignant mixed Müllerian tumors of the uterus. | 2001-04-15 |
|
| Impact of intravesical chemotherapy on recurrence rate of recurrent superficial transitional cell carcinoma of the bladder: results of a meta-analysis. | 2001-04-13 |
|
| Treatment of classical type Kaposi's sarcoma with paclitaxel. | 2001-04-13 |
|
| Reversal of multidrug resistance to epirubicin by cyclosporin A in liposomes or intralipid. | 2001-04-13 |
|
| Intensified chemotherapy supported by DMSO-free peripheral blood progenitor cells in breast cancer patients. | 2001-04 |
|
| Gemcitabine, epirubicin, and paclitaxel combinations in advanced breast cancer. | 2001-04 |
|
| Tolerability of the cytoprotective agent amifostine in elderly patients receiving chemotherapy: a comparative study. | 2001-04 |
|
| [Early phase II study of amrubicin (SM-5887) for superficial bladder cancer: a dose-finding study for intravesical chemotherapy]. | 2001-04 |
|
| High-dose epirubicin plus docetaxel at standard dose with lenograstim support as first-line therapy in advanced breast cancer. | 2001-04 |
|
| Clinical impacts of tumor cell contamination of hematopoietic stem cell products in metastatic breast cancer patients undergoing autologous peripheral blood stem cell transplantation: multicenter trial. | 2001-04 |
|
| Metastatic eccrine porocarcinoma: response to docetaxel (Taxotere) chemotherapy. | 2001-03 |
|
| Impact of chemotherapy dose-density on radiotherapy dose-intensity after breast conserving surgery. | 2001-03 |
|
| High incidence of central nervous system involvement in patients with metastatic or locally advanced breast cancer treated with epirubicin and docetaxel. | 2001-03 |
|
| Effective treatment with rituximab in a patient with refractory prolymphocytoid transformed B-chronic lymphocytic leukemia and Evans syndrome. | 2001-03 |
|
| A phase II study of dose-intense ifosfamide plus epirubicin with hematopoietic growth factors for the treatment of patients with advanced soft tissue sarcomas; a novel sequential schedule. | 2001-03 |
|
| Neurophysiological evaluation of late effects of adjuvant high-dose chemotherapy on cognitive function. | 2001-01 |
|
| Docetaxel and epirubicin in advanced breast cancer. | 2001 |
|
| Adjuvant chemotherapy with high-dose cyclophosphamide, etoposide and cisplatin intensification without progenitor cell support in breast cancer patients with ten or more involved nodes: 5-year results of a pilot trial. | 2001 |
|
| Dose-dense sequential adjuvant chemotherapy with epirubicin, paclitaxel and CMF in high-risk breast cancer. | 2001 |
|
| Intensive cyclic chemotherapy with unprocessed whole blood support in advanced breast cancer. | 2001 |
|
| Chemotherapy of metastatic breast cancer: what to expect in 2001 and beyond. | 2001 |
Sample Use Guides
Injection is administered to patients by intravenous infusion. Drug is given in 14 repeated 3- to 4-week cycles. The total dose may be given on Day 1 of each cycle 15 or divided equally and given on Days 1 and 8 of each cycle. The recommended starting dose is 100 to 120 mg/m2.
Route of Administration:
Intravenous
It was investigated the effect of combined treatment with the anthracycline agent epirubicin (EPI) and NK cells on human breast cancer cells. NK cells were obtained by autologous adoptive cell transfer from breast cancer patients and amplified for 14 days in vitro. The cytotoxicity of NK cells against breast cancer cells was higher following EPI (5.0 μg/ml) pretreatment than without EPI pretreatment or application of EPI alone. The expression of NKG2D ligands [unique long 16-binding protein (ULBP) 1, ULBP2, and major histocompatibility complex class I-related chain A] in breast cancer cells was upregulated by pretreatment with EPI, which also increased the secretion of interferon-γ and tumor necrosis factor-α and expression of perforin and granzyme B in NK cells. These results indicate that EPI-NK cell treatment has synergistic cytotoxic effects against breast cancer cells, and suggest that anthracycline-based chemotherapy and NK cell-based immunotherapy can be combined for more effective breast cancer treatment.
| Substance Class |
Polymer
Created
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admin
on
Edited
Tue Apr 01 20:39:48 GMT 2025
by
admin
on
Tue Apr 01 20:39:48 GMT 2025
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| Record UNII |
RQU6X0IM9R
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| Record Status |
Validated (UNII)
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| Record Version |
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Preferred Name | English | ||
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Code | English | ||
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Common Name | English |
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C139003
Created by
admin on Tue Apr 01 20:39:48 GMT 2025 , Edited by admin on Tue Apr 01 20:39:48 GMT 2025
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PRIMARY | NCIT | ||
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RQU6X0IM9R
Created by
admin on Tue Apr 01 20:39:48 GMT 2025 , Edited by admin on Tue Apr 01 20:39:48 GMT 2025
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ACTIVE MOIETY |
| Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
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| MOL_WEIGHT | CHEMICAL |
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