What is the strongest chemotherapy drug for breast cancer?

Medically reviewed by Carmen Pope, BPharm. Last updated on Jan 10, 2025.

Official Answer by Drugs.com

Doxorubicin is considered one of the strongest chemotherapy drugs for breast cancer ever invented. It can kill cancer cells at every point in their life cycle, and it's used to treat a wide variety of cancers, not just breast cancer. Doxorubicin is also known as “The Red Devil” because it is a clear bright red color. It can cause your urine or other body fluids to turn a reddish color for 1 to 2 days after a dose is given, which is normal and temporary.

Doxorubicin can cause harsh side effects such as heart toxicity (cardiotoxicity), severe nausea and vomiting, and total hair loss (alopecia). Because of its heart toxicity, doxorubicin has a maximum cumulative dose that can be given to each patient. The higher the total dose you receive over time, the greater your chance of heart side effects. Your doctor will monitor your heart before, during, and after doxorubicin treatment. Patients typically receive injections every 21 to 28 days on a specific cycle, but your dose schedule may be different.

Doxorubicin works by inhibiting an enzyme known as topoisomerase 2 and blocking RNA and DNA synthesis, which leads to cell death. Doxorubicin used to be marketed as the brand name product Adriamycin, but this has since been discontinued in the U.S., but the generic doxorubicin is still on the market. A liposomal form of doxorubicin (brand name: Doxil) is also available that allows doxorubicin to circulate in the blood for longer.

References

Christowitz, C., Davis, T., Isaacs, A. et al. Mechanisms of doxorubicin-induced drug resistance and drug-resistant tumor growth in a murine breast tumor model. BMC Cancer 19, 757 (2019). https://doi.org/10.1186/s12885-019-5939-z
Doxorubicin prescribing information. Revised 3/2020. New York, NY. Pfizer Inc. Accessed Dec. 7, 2021, at https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/050467s078,050629s030lbl.pdf
Doxorubicin monograph. Updated 03/2021 Hikma Pharmaceuticals USA Inc. https://www.drugs.com/pro/doxorubicin.html
Blanchard S. Can the Red Devil be Tamed? July 12, 2020. Accessed Dec. 7, 2021, at https://moffitt.org/endeavor/archive/can-the-red-devil-be-tamed/

What is the chemo drug called the Red Devil?

The chemotherapy (“chemo”) drug “The Red Devil” is doxorubicin (Adriamycin), an intravenous injection with a clear, bright red color used to treat various cancers. It may cause your urine or other body fluids to turn a reddish-orange color for 1 to 2 days after a dose is given, which is normal and temporary. Doxorubicin can also cause harsh side effects such as heart toxicity (heart failure), secondary cancers, severe vomiting and total hair loss (alopecia). Continue reading

Chemo side effects: What should I expect and how to cope?

Chemotherapy is a drug treatment used to kill fast-growing cancer cells in your body. While chemotherapy is an effective treatment for many types of cancer, it can also damage healthy cells that divide quickly, such as those in your hair follicles, digestive tract, and bone marrow. This widespread effect on healthy tissue is what causes the various side effects associated with chemotherapy treatment.

How long does chemo take? Sessions, cycles, and recovery time?

The duration of chemotherapy varies significantly based on cancer type, treatment goals, and individual patient health. Some patients may complete treatment in a few months, while others require therapy for a year or longer.

What is the strongest chemotherapy drug for breast cancer?

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What is the chemo drug called the Red Devil?

Chemo side effects: What should I expect and how to cope?

How long does chemo take? Sessions, cycles, and recovery time?

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