TY - JOUR
T1 - Paradoxical effect of capecitabine in 5-fluorouracil-induced cardiotoxicity
T2 - A case vignette and literature review
AU - Saneeymehri, Seyyedeh S.
AU - Markey, Kelly R.
AU - Mahipal, Amit
N1 - Publisher Copyright:
© The Author(s) 2015.
PY - 2016/6
Y1 - 2016/6
N2 - 5-fluorouracil is a chemotherapeutic agent that plays an important role in the treatment of various cancers including head and neck and gastrointestinal malignancies. Therapy with 5-fluorouracil is rarely associated with cardiotoxic effects including angina, heart failure, myocardial infarction and cardiac arrest, resulting in discontinuation at the expense of sub-optimal treatment of the targeted malignancy. In this article, we review the literature reported on 5-fluorouracil-associated cardiotoxicity and present a case of a patient who experienced chest pain on 5-fluorouracil. The cardiac symptoms subsided after initiation of capecitabine, the oral formulation of 5-fluorouracil. To our knowledge, this is only the second reported case where 5-fluorouracil was successfully replaced by capecitabine without recurrence of cardiac symptoms. Capecitabine may be a viable option for patients who develop 5-fluorouracil-induced chest pain. However, large clinical trials are warranted to confirm these findings. Currently, there is insufficient evidence to recommend an optimal approach for safe and effective alternative treatment for patients who experience 5-fluorouracil-induced cardiac adverse events.
AB - 5-fluorouracil is a chemotherapeutic agent that plays an important role in the treatment of various cancers including head and neck and gastrointestinal malignancies. Therapy with 5-fluorouracil is rarely associated with cardiotoxic effects including angina, heart failure, myocardial infarction and cardiac arrest, resulting in discontinuation at the expense of sub-optimal treatment of the targeted malignancy. In this article, we review the literature reported on 5-fluorouracil-associated cardiotoxicity and present a case of a patient who experienced chest pain on 5-fluorouracil. The cardiac symptoms subsided after initiation of capecitabine, the oral formulation of 5-fluorouracil. To our knowledge, this is only the second reported case where 5-fluorouracil was successfully replaced by capecitabine without recurrence of cardiac symptoms. Capecitabine may be a viable option for patients who develop 5-fluorouracil-induced chest pain. However, large clinical trials are warranted to confirm these findings. Currently, there is insufficient evidence to recommend an optimal approach for safe and effective alternative treatment for patients who experience 5-fluorouracil-induced cardiac adverse events.
KW - 5-fluorouracil
KW - capecitabine
KW - cardiotoxicity
KW - coronary vasospasm
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U2 - 10.1177/1078155215579303
DO - 10.1177/1078155215579303
M3 - Article
C2 - 25852107
AN - SCOPUS:84964241123
SN - 1078-1552
VL - 22
SP - 552
EP - 555
JO - Journal of Oncology Pharmacy Practice
JF - Journal of Oncology Pharmacy Practice
IS - 3
ER -