Date	Event	Description
24 February 2015	Amended	Contact details updated.
11 February 2015	Amended	Contact details updated.
27 March 2014	Amended	Contact details updated.
26 February 2014	Amended	Contact details updated.
9 May 2011	New search has been performed	The search for eligible studies was updated to November 2010.
9 May 2011	New citation required and conclusions have changed	Summary of most important changes in results of this second update when compared to the first update of this review: We identified a new randomised controlled trial (RCT) on the use of amifostine (no eligible data on amifostine were available before). Also, we identified a new RCT on the use of dexrazoxane and long‐term follow‐up data of an already included RCT on dexrazoxane. Finally, we identified a new ongoing trial (on enalapril maleate) and two new trials awaiting assessment (on telmirsartan and the combination of hydroprednisone and gluthatione). Again, only for dexrazoxane pooling of results was possible and for the occurrence of cardiotoxicity, response rate and survival the conclusions did not change. More information on adverse effects became available including secondary malignant disease.
19 August 2008	Amended	Converted to new review format.
18 February 2008	New citation required and conclusions have changed	Substantive amendment
10 July 2007	Amended	New studies found and included or excluded: 01/04/07 Conclusions changed: 10/07/07 Summary of most important changes in results of the update when compared to the original review: as opposed to the original review, there was no evidence for a lesser tumour response rate with the use of dexrazoxane. For adverse effects now pooling of results was possible: only for one adverse effect (abnormal white blood cell count at nadir) a difference in favour of the control group was identified. The search for eligible studies was updated to April 2007 using an updated search strategy and including eight new possible cardioprotective agents. And as opposed to the original review, for the update we searched in ongoing trials databases. Instead of pooling results when three or more randomised controlled trials (RCTs) were available, we now pooled results of two or more RCTs. Instead of focusing only on the primary outcome (heart failure) when assessing the quality of included studies, we now assessed the quality criteria blinding of the outcome assessor and completeness of follow‐up for all outcomes separately. Prior cardiac dysfunction was added as a baseline characteristic. Sex, age per treatment group, anthracycline peak dose, anthracycline infusion duration, cumulative anthracycline doses in the intervention and control groups, and a description of other chemotherapy and / or radiotherapy in the study protocol were added to the table of included studies. Five new RCTs were included: one addressing L‐carnitine, one addressing carvedilol and three additional ones addressing dexrazoxane. We also identified six ongoing studies and seven studies awaiting assessment evaluating different cardioprotective agents; characteristics of these trials are provided. Again, only for dexrazoxane pooling of results was possible and for the occurrence of cardiotoxicity and survival the conclusions did not change. As opposed to the original review, now there was no evidence for a lesser tumour response rate with the use of dexrazoxane. For adverse effects now pooling of results was possible: only for one adverse effect (abnormal white blood cell count at nadir) a difference in favour of the control group was identified. We conclude that if the risk of cardiac damage is expected to be high, it might be justified to use dexrazoxane in patients with cancer treated with anthracyclines. However, for each individual patient clinicians should weigh the cardioprotective effect of dexrazoxane against the possible risk of adverse effects.