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Epirubicin and mitoxantrone (novantrone) are both anthracycline-type chemotherapy drugs that have been studied in combination with other agents like fluorouracil and cyclophosphamide for treating metastatic breast cancer. Both drugs work by interfering with DNA synthesis and function, with epirubicin being a 4'-epi-isomer of doxorubicin. In clinical trials, epirubicin-containing regimens (FEC) showed better response rates than mitoxantrone-containing regimens (FNC), particularly in previously untreated patients and postmenopausal women. The main difference between these drugs is their toxicity profile - epirubicin causes more complete alopecia while mitoxantrone causes more significant hematological toxicity (leukopenia and thrombocytopenia).
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