Fluoropyrimidine-induced cardiotoxicity

Ilaria Depetris, Donatella Marino, Alessandro Bonzano, Celeste Cagnazzo, Roberto Filippi, Massimo Aglietta, Francesco Leone

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

Fluoropyrimidines (5-fluorouracil and capecitabine) are antimetabolite drugs, widely used for the treatment of a variety of cancers, both in adjuvant and in metastatic setting. Although the most common toxicities of these drugs have been extensively studied, robust data and comprehensive characterization still lack concerning fluoropyrimidine-induced cardiotoxicity (FIC), an infrequent but potentially life-threatening toxicity. This review summarizes the current state of knowledge of FIC with special regard to proposed pathogenetic models (coronary vasospasm, endothelium and cardiomyocytes damage, toxic metabolites, dihydropyrimidine dehydrogenase deficiency); risk and predictive factors; efficacy and usefulness in detection of laboratory markers, electrocardiographic changes and cardiac imaging; and specific treatment, including a novel agent, uridine triacetate. The role of alternative chemotherapeutic options, namely raltitrexed and TAS-102, is discussed, and, lastly, we overview the most promising future directions in the research on FIC and development of diagnostic tools, including microRNA technology.

Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalCritical Reviews in Oncology/Hematology
Volume124
DOIs
Publication statusPublished - Apr 1 2018

Fingerprint

Dihydropyrimidine Dehydrogenase Deficiency
Coronary Vasospasm
Antimetabolites
Poisons
Drug-Related Side Effects and Adverse Reactions
MicroRNAs
Cardiac Myocytes
Fluorouracil
Endothelium
Biomarkers
Technology
Research
Pharmaceutical Preparations
Cardiotoxicity
Neoplasms
Capecitabine
uridine triacetate
raltitrexed
Direction compound
TAS 102

Keywords

  • 5-Fluorouracil
  • Capecitabine
  • Cardiac toxicity
  • Cardiotoxicity
  • FIC
  • Fluoropyrimidines
  • Uridine triacetate
  • Vistogard

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Fluoropyrimidine-induced cardiotoxicity. / Depetris, Ilaria; Marino, Donatella; Bonzano, Alessandro; Cagnazzo, Celeste; Filippi, Roberto; Aglietta, Massimo; Leone, Francesco.

In: Critical Reviews in Oncology/Hematology, Vol. 124, 01.04.2018, p. 1-10.

Research output: Contribution to journalReview article

@article{673e4c93456b4422af3a740a42fa8abe,
title = "Fluoropyrimidine-induced cardiotoxicity",
abstract = "Fluoropyrimidines (5-fluorouracil and capecitabine) are antimetabolite drugs, widely used for the treatment of a variety of cancers, both in adjuvant and in metastatic setting. Although the most common toxicities of these drugs have been extensively studied, robust data and comprehensive characterization still lack concerning fluoropyrimidine-induced cardiotoxicity (FIC), an infrequent but potentially life-threatening toxicity. This review summarizes the current state of knowledge of FIC with special regard to proposed pathogenetic models (coronary vasospasm, endothelium and cardiomyocytes damage, toxic metabolites, dihydropyrimidine dehydrogenase deficiency); risk and predictive factors; efficacy and usefulness in detection of laboratory markers, electrocardiographic changes and cardiac imaging; and specific treatment, including a novel agent, uridine triacetate. The role of alternative chemotherapeutic options, namely raltitrexed and TAS-102, is discussed, and, lastly, we overview the most promising future directions in the research on FIC and development of diagnostic tools, including microRNA technology.",
keywords = "5-Fluorouracil, Capecitabine, Cardiac toxicity, Cardiotoxicity, FIC, Fluoropyrimidines, Uridine triacetate, Vistogard",
author = "Ilaria Depetris and Donatella Marino and Alessandro Bonzano and Celeste Cagnazzo and Roberto Filippi and Massimo Aglietta and Francesco Leone",
year = "2018",
month = "4",
day = "1",
doi = "10.1016/j.critrevonc.2018.02.002",
language = "English",
volume = "124",
pages = "1--10",
journal = "Critical Reviews in Oncology/Hematology",
issn = "1040-8428",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Fluoropyrimidine-induced cardiotoxicity

AU - Depetris, Ilaria

AU - Marino, Donatella

AU - Bonzano, Alessandro

AU - Cagnazzo, Celeste

AU - Filippi, Roberto

AU - Aglietta, Massimo

AU - Leone, Francesco

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Fluoropyrimidines (5-fluorouracil and capecitabine) are antimetabolite drugs, widely used for the treatment of a variety of cancers, both in adjuvant and in metastatic setting. Although the most common toxicities of these drugs have been extensively studied, robust data and comprehensive characterization still lack concerning fluoropyrimidine-induced cardiotoxicity (FIC), an infrequent but potentially life-threatening toxicity. This review summarizes the current state of knowledge of FIC with special regard to proposed pathogenetic models (coronary vasospasm, endothelium and cardiomyocytes damage, toxic metabolites, dihydropyrimidine dehydrogenase deficiency); risk and predictive factors; efficacy and usefulness in detection of laboratory markers, electrocardiographic changes and cardiac imaging; and specific treatment, including a novel agent, uridine triacetate. The role of alternative chemotherapeutic options, namely raltitrexed and TAS-102, is discussed, and, lastly, we overview the most promising future directions in the research on FIC and development of diagnostic tools, including microRNA technology.

AB - Fluoropyrimidines (5-fluorouracil and capecitabine) are antimetabolite drugs, widely used for the treatment of a variety of cancers, both in adjuvant and in metastatic setting. Although the most common toxicities of these drugs have been extensively studied, robust data and comprehensive characterization still lack concerning fluoropyrimidine-induced cardiotoxicity (FIC), an infrequent but potentially life-threatening toxicity. This review summarizes the current state of knowledge of FIC with special regard to proposed pathogenetic models (coronary vasospasm, endothelium and cardiomyocytes damage, toxic metabolites, dihydropyrimidine dehydrogenase deficiency); risk and predictive factors; efficacy and usefulness in detection of laboratory markers, electrocardiographic changes and cardiac imaging; and specific treatment, including a novel agent, uridine triacetate. The role of alternative chemotherapeutic options, namely raltitrexed and TAS-102, is discussed, and, lastly, we overview the most promising future directions in the research on FIC and development of diagnostic tools, including microRNA technology.

KW - 5-Fluorouracil

KW - Capecitabine

KW - Cardiac toxicity

KW - Cardiotoxicity

KW - FIC

KW - Fluoropyrimidines

KW - Uridine triacetate

KW - Vistogard

UR - http://www.scopus.com/inward/record.url?scp=85044863735&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044863735&partnerID=8YFLogxK

U2 - 10.1016/j.critrevonc.2018.02.002

DO - 10.1016/j.critrevonc.2018.02.002

M3 - Review article

VL - 124

SP - 1

EP - 10

JO - Critical Reviews in Oncology/Hematology

JF - Critical Reviews in Oncology/Hematology

SN - 1040-8428

ER -