ORAL IDARUBICIN - A REVIEW OF ITS PHARMACOLOGICAL PROPERTIES AND CLINICAL EFFICACY IN THE TREATMENT OF HEMATOLOGICAL MALIGNANCIES AND ADVANCED BREAST-CANCER

Idarubicin is an anthracycline agent available as both oral and intrav enous formulations. The oral formulation has demonstrated efficacy in the treatment of advanced breast cancer, low-grade non-Hodgkin's lymph oma, myelodysplastic syndromes and as first-line induction therapy of acute myelogenous leukaemia where intravenous anthracycline treatment is precluded. It also has potential in ameliorating blast crisis of ch ronic myelogenous leukaemia and in multiple myeloma. The most frequent adverse effects associated with oral idarubicin are those commonly fo und with anthracyclines, namely myelosuppression, nausea and vomiting, diarrhoea and mucositis. There appears to be minimal significant card iotoxicity with oral idarubicin. In summary, available data concerning oral idarubicin in haematological malignancies and advanced breast ca ncel. are sufficiently encouraging to warrant further research. To max imise the use of oral idarubicin, future studies should define the opt imal dose for elderly patients, its comparative efficacy with other av ailable regimens and address quality-of-life and pharmacoeconomic issu es associated with the substitution of oral for intravenous chemothera py.