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Medline ® Abstract for Reference 105

of 'Fluoropyrimidine-associated cardiotoxicity: Incidence, clinical manifestations, mechanisms, and management'

105
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Bolus 5-fluorouracil as an alternative in patients with cardiotoxicity associated with infusion 5-fluorouracil and capecitabine: a case series.
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Saif MW, Garcon MC, Rodriguez G, Rodriguez T
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In Vivo. 2013 Jul;27(4):531-4.
 
BACKGROUND: 5-Fluorouracil (5-FU) is the backbone of chemotherapy regimens approved for treatment of colorectal cancer. The incidence of cardiotoxicity associated with 5-FU ranges from 1.5% to 18%; 48% as anginal symptoms and 2% as cardiogenic shock. Cardiotoxicity is unpredictable and no alternative chemotherapeutics have been defined so far.
PATIENTS AND METHODS: We present a case series of six patients who developed cardiotoxicity on infusional fluorouracil and/or capecitabine and were challenged with bolus 5-FU for the treatment of their malignancies. Four patients were tested for polymorphic abnormality of the human dihydropyrimidine dehydrogenase gene (DPYD) with the TheraGuide 5-FU™(Myriad Genetic Laboratories, Inc., Salt Lake City, UT, USA) pharmacogenetic test.
RESULTS: Five patients were challenged with oral capecitabine that reproduced clinical and/or diagnostic concerns. All six patients tolerated bolus 5-FU either as a radiosensitizing agent or as chemotherapy without recurrence of a cardiac insult. DPYD was normal in thefour patients tested.
CONCLUSION: Cardiotoxicity induced by 5-FU seems to be schedule-dependent. Bolus 5-FU can be used in patients developing cardiotoxicity due to 5-FU infusion or capecitabine with vigilance.
AD
Section of GI Cancers and Experimental Therapeutics, Tufts University School of Medicine, Boston, MA 02111, USA. wsaif@tuftsmedicalcenter.org
PMID