Dexrazoxane + Trimetazidine

The combination of dexrazoxane and trimetazidine is a cardioprotective therapy primarily used to prevent or reduce anthracycline-induced cardiotoxicity, a common side effect of chemotherapy drugs like doxorubicin, daunorubicin, epirubicin, and idarubicin. Dexrazoxane is a cytoprotective drug that works by inhibiting the formation of toxic iron-anthracycline complexes. It acts as an iron chelator, thereby providing cardioprotection against anthracycline-induced cardiotoxicity and can also decrease damage to skin and tissues from anthracycline extravasation during injection. Trimetazidine demonstrates a cardioprotective effect comparable to dexrazoxane in protecting against subacute and chronic subclinical cardiotoxicity. It appears to work synergistically with dexrazoxane, offering enhanced protection against heart damage. Clinical evidence suggests that this combination therapy leads to improvements in ECG abnormalities and reduced levels of cardiac biomarkers such as cTnT, CK, and cTnI. This combination therapy is particularly relevant for cancer patients, especially those with metastatic breast cancer receiving anthracycline-based chemotherapy, who are at a high risk of developing cardiomyopathy.