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Anthracycline Extravasation — SCE Medical Oncology MCQ

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HardOncological EmergenciesAnthracycline ExtravasationSCE Medical Oncology

A 58-year-old woman with advanced gastric cancer develops an extravasation injury during administration of doxorubicin. There is erythema and pain around the IV site with a blister forming. What is the specific antidote for anthracycline extravasation?

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Correct answer: E — Stop the infusion and start intravenous dexrazoxane within six hours

Anthracycline extravasation requires prompt infusion cessation and intravenous dexrazoxane started within six hours when indicated. Stop the infusion and infiltrate sodium thiosulfate within six hours: sodium thiosulfate is paired with other vesicants rather than anthracycline extravasation. Stop the infusion and infiltrate hyaluronidase within six hours: hyaluronidase is used for taxane or vinca extravasation in relevant protocols. Stop the infusion and apply dimethyl sulfoxide with local warming: topical DMSO may be used in some protocols but is not combined with warmth and is not the specific systemic antidote requested. Stop the infusion and arrange immediate operative debridement within six hours: early surgery is not the first antidotal step for a fresh anthracycline extravasation.

Reference: Savene UK summary of product characteristics (Current UK SmPC, accessed July 2026): https://www.medicines.org.uk/emc/product/100471/smpc