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Summary
Cardiotoxicity is a rare but challenging complication of 5-fluorouracil (5-FU) therapy. Compared with 5-FU, after application of S-1 lower plasma levels of the cardiotoxic metabolite alpha-fluoro-beta-alanine have been reported. Evidence for safe administration of S-1 following 5-FU cardiotoxicity is limited to a case report in an Asian patient. Herein we report the first case of S-1 application after 5-FU cardiotoxicity in a Caucasian patient.
A 67-year-old man with right-sided metastatic colorectal cancer and history of 5-FU cardiotoxicity had a progressive disease after 8-month therapy with irinotecan and bevacizumab. In consideration of known 5-FU cardiotoxicity, he was referred to our department for therapy counselling. We started a combination therapy with S-1, oxaliplatin and bevacizumab. The treatment was well tolerated without any cardiac problems.
Our report confirms the safety of S-1 in cases of 5-FU cardiotoxicity also in a Caucasian patient.
- cancer intervention
- gastroenterology
- drugs and medicines
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Footnotes
Contributors MV is the guarantor of the article. He had the idea for the article. MV identified and managed the case. CF carefully reviewed the course of the case, performed the literature search and primary drafted the article. PM and MV revised the manuscript critically for important intellectual content. All authors gave final approval of the current version of the article.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.