Pillar 1 - FTO (new thread), page-2887

Like the anthracyclines, bisantrene has multiple mechanisms of action too.

It is worth remembering how drugs like doxorubicin and bisantrene were discovered and first used. Until the 1990s most cancer drugs were only used one at a time (no combinations) in solid tumours. This use pattern selects for drugs that have multiple mechanisms of action since having multiple mechanisms of action makes the drug work in a much wider range of cancer types (there were no biomarkers to use to target specific cancer sub-types before 2000) and reduces the chance of resistance arising. These ‘old’ anticancer drugs are all really a drug combination ('drug cocktail’ ) in one molecule. This is why they are so effective and continue to be so widely used to this day.

This is a long way of saying that cardioprotection may not just be due to bisantrene targeting one mechanism of action.