Cardiotoxicity occurs in 4%-6% during capecitabine- or 5-FU-based treatment and often leads to treatment discontinuation.This is the largest patient series switched to S-1-based treatment after cardiotoxicity on fluoropyrimidine treatment.We show that 96% of 200 patients had no recurrent cardiotoxicity upon switch to S-1; grade 1-2 was seen in 4%.The essential fluoropyrimidine treatment, as S-1-based chemotherapy, was completed in 99% of patients.S-1 is feasible for life-prolonging or lifesaving treatment when capecitabine/5-FU is discontinued due to cardiotoxicity.Fluoropyrimidines, including oral capecitabine and continuous infusion or bolus 5-fluorouracil (5-FU), are the cornerstone of curative or life-prolonging chemotherapy in many solid tumours.Cardiotoxicity is a common and potentially lethal complication of fluoropyrimidine treatment, with a reported incidence varying between 0% and 35%, depending on assessment method, dose, and schedule. Cardiologist verified population- or trial-based reports demonstrate cardiotoxicity incidence rates of 4%-6% in patients receiving capecitabine or infused 5-FU.

Angina-like chest pain, with or without ischemia, is the predominant clinical presentation, and frequently occurs early after fluoropyrimidine administration.6,8 Serious or life-threatening adverse events, including acute coronary syndrome, myocardial infarction, arrhythmias, heart failure, cardiogenic shock, and sudden death, have each been reported in 0.1%-4.6%. Most cardiotoxic events leading to permanent discontinuation occur within days from treatment initiation, with the consequence that these patients derive no benefit from this treatment. Dose reduction and rechallenge lead to recurrence of cardiotoxicity in 44%-90% of patients, even with prophylactic calcium blocker or nitrate treatment. This illustrates the challenge of continuing potentially beneficial fluoropyrimidine treatment once cardiotoxicity has occurred.

visit for more articles at Journal of Heart and Cardiovascular Research

Kindly submit your article at  https://www.imedpub.com/submissions/heart-cardiovascular-research.html

Regards
Mishita
Jornal co-ordinator
Journal of Heart and Cardiovascular Research