Pharmacokinetic evaluation of pixantrone for the treatment of non-Hodgkin's lymphoma

Introduction: Pixantrone is a novel aza-anthracenedione, similar in structure to anthracyclines, including the anthracycline derivative mitoxantrone. There is no standard therapy for relapsed or refractory aggressive non-Hodgkin's lymphoma (NHL) in patients who have received two prior lines of therapy. Pixantrone does not bind iron, promotes reactive oxygen species to a lesser degree than other anthracyclines and is therefore believed to be less cardiotoxic without compromising efficacy. Areas covered: This article outlines the chemical properties of pixantrone, as well as the preclinical and clinical studies looking at pixantrone in the treatment of both indolent and aggressive NHL. Expert opinion: Pixantrone is an active and safe drug that has been shown to be of benefit when used to treat patients with relapsed aggressive NHL in the context of Phase II and Phase III studies. It was superior to other single-agent therapies in this context and in combination therapy may be the treatment of choice in order to avoid cardiac toxicity. Potentially it is a more effective and less cardiotoxic alternative to doxorubicin in patients with aggressive NHL.