Capecitabine-induced cardiotoxicity: More evidence or clinical approaches to protect the patients' heart?

Caterina Fontanella, Marianna Aita, Marika Cinausero, Giuseppe Aprile, Gianpiero Fasola, Fabio Puglisi, Maria Grazia Baldin, Veronica Dusi, Chiara Lestuzzi, Fabio Puglisi

Research output: Contribution to journalArticlepeer-review


Fluoropyrimidines, such as capecitabine and 5-fluorouracil, may cause cardiac toxicity. In recent years, the incidence of this side effect has increased and it is expected to further rise due to the population aging and the disproportionate incidence of breast and gastrointestinal cancers in older individuals. The spectrum of cardiac manifestations includes different signs and symptoms and the diagnosis may be difficult. Here, we report the case of a 43-year-old woman with advanced breast cancer who was rechallenged with a capecitabine-based regimen after experiencing a cardiac adverse event during the first fluoropyrimidine exposure. This real-practice case serves as a springboard for discussion about the current evidence on differential diagnosis of capecitabine-related cardiac toxicity, its risk factors, and the underpinning mechanisms of early onset. Moreover, we discussed whether a rechallenge with fluoropyrimidines could be safe in patients who had experienced a previous cardiac adverse event.

Original languageEnglish
Pages (from-to)1783-1791
Number of pages9
JournalOncoTargets and Therapy
Publication statusPublished - Sep 29 2014


  • Clinical manifestation
  • Rechallenge
  • Risk factors

ASJC Scopus subject areas

  • Oncology
  • Pharmacology (medical)


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