Key result
Early fluoropyrimidine discontinuation prevents progression and mortality in two patients with severe cardiotoxicity.
Why the study?
Fluoropyrimidine-induced cardiotoxicity and neurotoxicity are uncommon but serious side effects, with infusional 5-FU regimens associated with more adverse events than bolus forms.
Does early withholding of fluoropyrimidine treatment prevent progression and mortality in patients experiencing cardiotoxicity and neurotoxicity?
Case Report (n=2)
Does early withholding of fluoropyrimidine treatment prevent progression and mortality in patients experiencing cardiotoxicity and neurotoxicity?
Early withholding of fluoropyrimidine therapy in patients developing cardiotoxicity or neurotoxicity may prevent clinical progression and mortality.
Fluoropyrimidines (FP's) such as fluorouracil (5-FU) and capecitabine are antimetabolites widely used in many solid tumors. FPs side effects are caused mainly by a lack of dihydropyrimidine dehydrogenase (DPD) enzyme. It has been noticed that treatment with infusional regimens of 5-FU is associated with more adverse events (AE) compared to bolus forms. Here, we report two cases of unusual side effects seen with infusional 5-FU and capecitabine and how early intervention by withholding ongoing treatment can help in preventing progression and mortality.
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Sethi et al. (2022) conducted a case report in Fluoropyrimidine-induced cardiotoxicity and neurotoxicity (n=2). Fluoropyrimidines (infusional 5-FU and capecitabine) was evaluated. In two patients experiencing severe cardiotoxicity and neurotoxicity from fluoropyrimidines, early intervention by modifying the regimen prevented progression and mortality.
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