RT Journal Article
SR Electronic
T1 Treatment of advanced colorectal cancer in a patient with cardiotoxic reactions to 5-fluorouracil and capecitabine using suboptimal doses
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2017-220952
DO 10.1136/bcr-2017-220952
VO 2017
A1 Joseph H Cioffi
A1 Derek J Estes
A1 Vaia Florou
A1 Bach Ardalan
YR 2017
UL http://casereports.bmj.com/content/2017/bcr-2017-220952.abstract
AB A 32-year-old female with stage IV colorectal cancer and metastasis to the liver experienced cardiotoxic reactions after treatment with 5-fluorouracil and its oral prodrug capecitabine even at two-thirds the recommended dose. After careful considerations, the decision was made to attempt capecitabine retrial at a further suboptimal dose with combination chemotherapy where she no longer experienced cardiac events. As a result, the liver tumour shrank and rectal mass stabilised, tumour markers dropped and she underwent surgical resection of both masses. Later there was local recurrence of disease near the previous liver tumour, so the suboptimal capecitabine therapy was restarted without complaint. The patient became a candidate for a NanoKnife procedure, offering a potentially curative therapy. This case report summarises a novel treatment strategy for those patients with advanced colorectal cancer who experience cardiotoxic reactions to fluoropyrimidines, the active agent of gold standard treatment.