Management of Fluoropyrimidine-Induced Cardiac Adverse Outcomes Following Cancer Treatment.

Autor: Rajaeinejad M; AJA Cancer Epidemiology Research and Treatment Center (AJA-CERTC), AJA University of Medical Sciences, Tehran, Iran., Parhizkar-Roudsari P; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical sciences, Tehran, Iran.; Iranian Cancer Control Center, Tehran, Iran., Khoshfetrat M; Department of Cardiology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran., Kazemi-Galougahi MH; Department of Social Medicine, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran., Mosaed R; Infection Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran.; Student Research Committee, AJA University of Medical Sciences, Tehran, Iran., Arjmand R; Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran., Mohsenizadeh SA; Department of Cardiology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran. Dr.mohseni959@gmail.com., Arjmand B; Department of Internal Medicine, School of Medicine, AJA University of Medical Sciences, Tehran, Iran. barjmand@sina.tums.ac.ir.
Jazyk: angličtina
Zdroj: Cardiovascular toxicology [Cardiovasc Toxicol] 2024 Feb; Vol. 24 (2), pp. 184-198. Date of Electronic Publication: 2024 Feb 07.
DOI: 10.1007/s12012-024-09834-9
Abstrakt: Advancements in cancer treatments have improved survival rates but have also led to increased cardiotoxicities, which can cause adverse cardiovascular events or worsen pre-existing conditions. Herein, cardiotoxicity is a severe adverse effect of 5-fluorouracil (5-FU) therapy in cancer patients, with reported incidence rates ranging from 1 to 20%. Some studies have also suggested subclinical effects and there are reports which have documented instances of cardiac arrest or sudden death during 5-FU treatment, highlighting the importance of timely management of cardiovascular symptoms. However, despite being treated with conventional medical approaches for this cardiotoxicity, a subset of patients has demonstrated suboptimal or insufficient responses. The frequent use of 5-FU in chemotherapy and its association with significant morbidity and mortality indicates the need for a greater understanding of 5-FU-associated cardiotoxicity. It is essential to reduce the adverse effects of anti-tumor medications while preserving their efficacy, which can be achieved through drugs that mitigate toxicity associated with these drugs. Underpinning cardiotoxicity associated with 5-FU therapy also has the potential to offer valuable guidance in pinpointing pharmacological approaches that can be employed to prevent or ameliorate these effects. The present study provides an overview of management strategies for cardiac events induced by fluoropyrimidine-based cancer treatments. The review encompasses the underlying molecular and cellular mechanisms of cardiotoxicity, associated risk factors, and diagnostic methods. Additionally, we provide information on several available treatments and drug choices for angina resulting from 5-FU exposure, including nicorandil, ranolazine, trimetazidine, ivabradine, and sacubitril-valsartan, which have demonstrated potential in mitigating or protecting against chemotherapy-induced adverse cardiac effects.
(© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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