Treatment of advanced colorectal cancer in a patient with cardiotoxic reactions to 5-fluorouracil and capecitabine using suboptimal doses
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 capecitabin...
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| creator | Cioffi, Joseph H Estes, Derek J Florou, Vaia Ardalan, Bach |
| description | 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. |
| doi_str_mv | 10.1136/bcr-2017-220952 |
| format | Article |
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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.</description><identifier>ISSN: 1757-790X</identifier><identifier>EISSN: 1757-790X</identifier><identifier>DOI: 10.1136/bcr-2017-220952</identifier><identifier>PMID: 29183892</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Analgesics ; Biopsy ; Cancer therapies ; Cardiovascular disease ; Case reports ; Chemotherapy ; Colorectal cancer ; Female ; Liver ; Medical imaging ; Metastasis ; Novel Treatment (New Drug/Intervention; Established Drug/Procedure in New Situation) ; Ostomy ; Pain ; Patients ; Risk factors ; Systematic review ; USA/Canada ; White</subject><ispartof>BMJ case reports, 2017-11, Vol.2017, p.bcr-2017-220952</ispartof><rights>BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. 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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.</description><subject>Analgesics</subject><subject>Biopsy</subject><subject>Cancer therapies</subject><subject>Cardiovascular disease</subject><subject>Case reports</subject><subject>Chemotherapy</subject><subject>Colorectal cancer</subject><subject>Female</subject><subject>Liver</subject><subject>Medical imaging</subject><subject>Metastasis</subject><subject>Novel Treatment (New Drug/Intervention; Established Drug/Procedure in New Situation)</subject><subject>Ostomy</subject><subject>Pain</subject><subject>Patients</subject><subject>Risk factors</subject><subject>Systematic review</subject><subject>USA/Canada</subject><subject>White</subject><issn>1757-790X</issn><issn>1757-790X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkc1LHDEYxoNUdFHP3kqgt8LUfEw2k0uhSG0FwYuCt5CvWbPMJtMks9Y_wf_aDLsVezKXN-R98nuflweAc4y-YUyXF9qkhiDMG0KQYOQALDBnvOECPXx6dz8GZzmvUT0Ut11Lj8AxEbijnSAL8HKXnCobFwqMPVR2q4JxFpo4xORMUQM080uCPkAFR1X8LH3y5bE2kvWxxL_ewAoxxceQYYmQNf0wxRSnpIwfoAqVp0ZnfFHaBwen7MMK5knHsfhNHWFjdvkUHPZqyO5sX0_A_dXPu8vfzc3tr-vLHzeNphyThhGurSbaaLXsOOmVVlpzZlxnLe573ZkWO8t0LcQYRlvRMdQhJHrnCGWYnoDvO-446Y2zpu6T1CDHVK2kZxmVl_93gn-Uq7iVjBNERVsBX_aAFP9MLhe5rquG6llisRSMcsTnMRc7lUkx5-T6twkYyTk-WeOTc3xyF1_98fm9sTf9v7Cq4OtOoDfrD2mvPbunyQ</recordid><startdate>20171127</startdate><enddate>20171127</enddate><creator>Cioffi, Joseph H</creator><creator>Estes, Derek J</creator><creator>Florou, Vaia</creator><creator>Ardalan, Bach</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20171127</creationdate><title>Treatment of advanced colorectal cancer in a patient with cardiotoxic reactions to 5-fluorouracil and capecitabine using suboptimal doses</title><author>Cioffi, Joseph H ; 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| subjects | Analgesics Biopsy Cancer therapies Cardiovascular disease Case reports Chemotherapy Colorectal cancer Female Liver Medical imaging Metastasis Novel Treatment (New Drug/Intervention Established Drug/Procedure in New Situation) Ostomy Pain Patients Risk factors Systematic review USA/Canada White |
| title | Treatment of advanced colorectal cancer in a patient with cardiotoxic reactions to 5-fluorouracil and capecitabine using suboptimal doses |
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