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Fluoropyrimidine Cardiotoxicity: Incidence, Outcomes, and Safety of Rechallenge. | LitMetric

Fluoropyrimidine Cardiotoxicity: Incidence, Outcomes, and Safety of Rechallenge.

Curr Oncol Rep

Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indiana University, 1800 N. Capitol Ave, E308, Indianapolis, IN, 46202, USA.

Published: July 2022

AI Article Synopsis

  • Fluoropyrimidine (FDP) chemotherapy significantly benefits patients with solid tumors, but can also cause cardiotoxicity, leading to stopped treatments.
  • Up to 35% of patients experience symptoms like chest pain and heart problems due to FDP, making it crucial for caregivers to identify risk factors.
  • Resuming FDP treatment after cardiac issues is possible with proper management strategies, emphasizing collaboration between oncologists and cardiologists to improve patient outcomes.

Article Abstract

Purpose Of Review: Fluoropyrimidine (FDP) chemotherapy regimens used in the treatment of solid tumors such as breast, gastrointestinal, and hepatobiliary malignancies have led to significant survival benefits. However, FDP cardiotoxicity can lead to premature termination of FDP-based chemotherapy treatments. Resuming these crucial therapies after initial FDP cardiotoxicity can be challenging for patients and healthcare providers.

Recent Findings: Symptomatic cardiotoxicity occurs in up to 35% of patients treated with FDP-based chemotherapy. The most common symptom is chest pain, but palpitations, dyspnea, myocardial infarction, cardiogenic shock, and cardiac arrest can also occur. Several large studies have attempted to discern clinical and genetic risk factors in those who develop FDP cardiotoxicity. With cardiac risk factor optimization and aggressive pre-treatment with anti-anginal agents, rechallenging with FDP is possible and allows patients to resume optimal cancer-directed treatment. FDP cardiotoxicity remains a poorly understood identity. We highlight several recent publications attempting to define the risk factors associated with developing FDP cardiotoxicity. The management of FDP cardiotoxicity and consideration of rechallenge of FDP-based regimens highlights the importance of a multidisciplinary partnership between oncologists and cardiologists/cardio-oncologists.

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11912-022-01256-6DOI Listing

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