Which statement about cumulative dosing in chemotherapy is correct?

• A. Most agents require no cap on lifetime dose.
• B. Cumulative dose monitoring is important for anthracyclines due to risk of cardiotoxicity.
• C. All anticancer agents are given as fixed doses.
• D. Cumulative dose monitoring is important for alkylating agents due to nephrotoxicity.

Answer: (B)

The key idea is that some chemotherapy drugs have toxic effects that accumulate with total exposure, so tracking the lifetime dose helps prevent irreversible harm. Anthracyclines, like doxorubicin, are the classic example: their risk of heart damage increases with each cycle, and the damage is dose‑dependent. Because of this, clinicians impose a lifetime cumulative dose limit and adjust or stop treatment when that limit is approached to protect cardiac function. This is why monitoring cumulative dose is emphasized for anthracyclines.

Other statements aren’t as holding: many drugs aren’t given with no cap on lifetime exposure, and dosing is tailored rather than fixed for all patients. While some alkylating agents can cause nephrotoxicity, the primary and most well‑established reason to monitor cumulative dose is the cardiotoxic risk associated with anthracyclines.