Why the study?
Gemcitabine is generally considered safe with few reported cardiac adverse effects, but gemcitabine-induced dilated cardiomyopathy had not been objectively documented in ovarian serous adenocarcinoma without prior cardiac history.
This case highlights the rare but severe risk of gemcitabine-induced dilated cardiomyopathy, emphasizing the need for prompt diagnosis and management with standard heart failure therapy.
Alerts clinicians to reversible gemcitabine cardiomyopathy; single case leaves open need for incidence and monitoring studies.
Gemcitabine is a nucleoside analogue and pyrimidine antimetabolite authorized for the treatment of ovarian cancer. It is generally considered safe and well-tolerated, with only a few reported cases of cardiac adverse effects. However, we present a case of gemcitabine-induced dilated cardiomyopathy in a 33-year-old female receiving gemcitabine as second-line therapy for ovarian serous adenocarcinoma. The patient had no history of hypertension or significant cardiac issues. She presented with clinical symptoms, laboratory abnormalities, and imaging findings consistent with congestive cardiac failure, along with a Left Ventricular Ejection Fraction (LVEF) of 25-30%. Gemcitabine administration was immediately discontinued, and treatment with Furosemide, ACE inhibitors, and Beta-blocker agents was initiated. Subsequently, the patient’s condition improved, with the resolution of symptoms and normalization of cardiac findings upon discontinuation of gemcitabine. This is the first reported case demonstrating objective evidence of gemcitabine-induced dilated cardiomyopathy in a patient with ovarian serous adenocarcinoma without a significant cardiac history. Although rare, it is crucial to promptly diagnose gemcitabine-induced cardiomyopathy to initiate appropriate management protocols.
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Nabeel et al. (2023) studied this question.
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