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Continuation of flu...
Continuation of fluoropyrimidine treatment with S-1 after cardiotoxicity on capecitabine- or 5-fluorouracil-based therapy in patients with solid tumours : a multicentre retrospective observational cohort study
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- Osterlund, P. (författare)
- Karolinska Institutet
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- Kinos, S. (författare)
- Tampere Univ Hosp, Dept Oncol, Tampere, Finland.;Univ Tampere, Tampere, Finland.
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- Pfeiffer, P. (författare)
- Odense Univ Hosp, Dept Oncol, Odense, Denmark.
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- Salminen, T. (författare)
- Tampere Univ Hosp, Dept Oncol, Tampere, Finland.;Univ Tampere, Tampere, Finland.
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- Kwakman, J. J. M. (författare)
- Amsterdam Univ Med Ctr, Dept Oncol, Amsterdam, Netherlands.
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- Frodin, J-E (författare)
- Karolinska Institutet
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- Shah, C. H. (författare)
- Karolinska Univ Hosp, Dept Oncol, Stockholm, Sweden.
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- Sorbye, H. (författare)
- Haukeland Hosp, Dept Oncol, Bergen, Norway.;Univ Bergen, Dept Clin Sci, Bergen, Norway.
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- Ristamaki, R. (författare)
- Turku Univ Hosp, Dept Oncol, Turku, Finland.;Univ Turku, Turku, Finland.
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- Halonen, P. (författare)
- Helsinki Univ Hosp, Dept Oncol, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.
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- Soveri, L. M. (författare)
- Helsinki Univ Hosp, Dept Oncol, Helsinki, Finland.;Univ Helsinki, Helsinki, Finland.
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- Heerva, E. (författare)
- Turku Univ Hosp, Dept Oncol, Turku, Finland.;Univ Turku, Turku, Finland.
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- Algars, A. (författare)
- Turku Univ Hosp, Dept Oncol, Turku, Finland.;Univ Turku, Turku, Finland.
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- Barlund, M. (författare)
- Tampere Univ Hosp, Dept Oncol, Tampere, Finland.;Univ Tampere, Tampere, Finland.
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- Hagman, H. (författare)
- Skane Univ Hosp, Dept Oncol, Lund, Sweden.
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- McDermott, R. (författare)
- St Vincents Univ Hosp, Dept Oncol, Dublin, Ireland.
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- O'Reilly, M. (författare)
- St Vincents Univ Hosp, Dept Oncol, Dublin, Ireland.
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- Röckert, R. (författare)
- Uppsala Univ Hosp, Dept Oncol, Uppsala, Sweden.
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- Liposits, G. (författare)
- Odense Univ Hosp, Dept Oncol, Odense, Denmark.;Reg Hosp West Jutland, Dept Oncol, Herning, Denmark.
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- Kallio, R. (författare)
- Tampere Univ Hosp, Dept Oncol, Tampere, Finland.;Univ Tampere, Tampere, Finland.;Oulu Univ Hosp, Dept Oncol, Oulu, Finland.
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- Flygare, P. (författare)
- Sundsvall Hosp, Dept Oncol, Sundsvall, Sweden.
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- Teske, A. J. (författare)
- Univ Med Ctr Utrecht, Dept Cardiol, Utrecht, Netherlands.
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- van Werkhoven, E. (författare)
- Netherlands Canc Inst, Dept Biometr, Amsterdam, Netherlands.
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- Punt, C. J. A. (författare)
- Univ Utrecht, Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Dept Epidemiol, Utrecht, Netherlands.
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- Glimelius, Bengt (författare)
- Uppsala universitet,Cancerprecisionsmedicin
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Karolinska Institutet Tampere Univ Hosp, Dept Oncol, Tampere, Finland;Univ Tampere, Tampere, Finland. (creator_code:org_t)
- Elsevier, 2022
- 2022
- Engelska.
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Ingår i: ESMO Open. - : Elsevier. - 2059-7029. ; 7:3
- Relaterad länk:
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Background: Capecitabine- or 5-fluorouracil (5-FU)-based chemotherapy is widely used in many solid tumours, but is associated with cardiotoxicity. S-1 is a fluoropyrimidine with low rates of cardiotoxicity, but evidence regarding the safety of switching to S-1 after 5-FU- or capecitabine-associated cardiotoxicity is scarce.Patients and methods: This retrospective study (NCT04260269) was conducted at 13 centres in 6 countries. The primary endpoint was recurrence of cardiotoxicity after switch to S-1-based treatment due to 5-FU- or capecitabine-related cardiotoxicity: clinically meaningful if the upper boundary of the 95% confidence interval (CI; by competing risk) is not including 15%. Secondary endpoints included cardiac risk factors, diagnostic work-up, treatments, outcomes, and timelines of cardiotoxicity.Results: Per protocol, 200 patients, treated between 2011 and 2020 [median age 66 years (range 19-86); 118 (59%) males], were included. Treatment intent was curative in 145 (73%). Initial cardiotoxicity was due to capecitabine (n = 170), continuous infusion 5-FU (n = 22), or bolus 5-FU (n = 8), which was administered in combination with other chemotherapy, targeted agents, or radiotherapy in 133 patients. Previous cardiovascular comorbidities were present in 99 (50%) patients. Cardiotoxic events (n = 228/200) included chest pain (n = 125), coronary syndrome/ infarction (n = 69), arrhythmia (n = 22), heart failure/cardiomyopathy (n = 7), cardiac arrest (n = 4), and malignant hypertension (n = 1). Cardiotoxicity was severe or life-threatening in 112 (56%) patients and led to permanent capecitabine/5-FU discontinuation in 192 (96%). After switch to S-1, recurrent cardiotoxicity was observed in eight (4%) patients (95% CI 2.02-7.89, primary endpoint met). Events were limited to grade 1-2 and occurred at a median of 16 days (interquartile range 7-67) from therapy switch. Baseline ischemic heart disease was a risk factor for recurrent cardiotoxicity (odds ratio 6.18, 95% CI 1.36-28.11).Conclusion: Switching to S-1-based therapy is safe and feasible after development of cardiotoxicity on 5-FU- or capecitabine-based therapy and allows patients to continue their pivotal fluoropyrimidine-based treatment.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- cardiac toxicity
- cardiotoxicity
- fluoropyrimidines
- S-1
- gastrointestinal cancer
- colorectal cancer
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
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Osterlund, P.
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Kinos, S.
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Pfeiffer, P.
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Salminen, T.
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Kwakman, J. J. M ...
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Frodin, J-E
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visa fler...
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Shah, C. H.
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Sorbye, H.
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Ristamaki, R.
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Halonen, P.
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Soveri, L. M.
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Heerva, E.
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Algars, A.
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Barlund, M.
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Hagman, H.
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McDermott, R.
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O'Reilly, M.
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Röckert, R.
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Liposits, G.
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Kallio, R.
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Flygare, P.
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Teske, A. J.
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van Werkhoven, E ...
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Punt, C. J. A.
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Glimelius, Bengt
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visa färre...
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