Can Folfirinox cause heart problems?
Cardiotoxicity observed with FU includes myocardial infarction/ischemia, angina, dysrhythmias, cardiac arrest, cardiac failure, sudden death, ECG changes, and cardiomyopathy.
Is 5-FU a cardiotoxic?
5-fluorouracil (5-FU) is a fluoropyrimidine (FP) antimetabolite agent used in a variety of solid tumors treatment. A potential severe side effect of 5-FU is cardiotoxicity, which often presents with chest pain related to coronary vasospasm.
Which chemotherapy agents can cause cardiotoxicity?
Cytostatic antibiotics of the anthracycline class are the best known of the chemotherapeutic agents that cause cardiotoxicity. Alkylating agents such as cyclophosphamide, ifosfamide, cisplatin, carmustine, busulfan, chlormethine and mitomycin have also been associated with cardiotoxicity.
Is doxorubicin toxic to the heart?
It is well recognized that doxorubicin may cause damage to the heart in some individuals. While other anthracyclines (like epirubicin and mitoxantrone) may also cause heart damage, the chances are more common with doxorubicin. Doxorubicin causes both early and late heart damage (also called cardiotoxicity).
How long can you stay on FOLFIRINOX?
Each cycle of treatment lasts 2 weeks. Depending on your needs, you may have up to 12 cycles, taking 6 months in total. You have oxaliplatin as a drip into your vein over 2 hours. You have folinic acid as a drip into your vein over 2 hours at the same time you have oxaliplatin.
How toxic is FOLFIRINOX?
Unfortunately, the incremental activity of FOLFIRINOX comes at the expense of increased toxicity. High rates of grades 3–4 neutropenia (45.7%), fatigue (23.6%), vomiting (14.5%) and diarrhea (12.7%) have been reported in ACCORD 11/PRODIGE 4.
Is capecitabine cardiotoxic?
In summary, cardiotoxicity induced by 5fu or capecitabine has multiple manifestations and may occur more frequently than previously reported. Although this cardiotoxicity is transient and often reversible, it has the potential to cause serious morbidity and even mortality.
Can oxaliplatin cause heart problems?
Cisplatin chemotherapy is also associated with cardiotoxic effects that may range from silent arrhythmias to heart failure and even sudden cardiac death. These effects are more pronounced when cisplatin is combined with other cardiotoxic drugs.
Is doxorubicin cardiotoxicity reversible?
Because severe doxorubicin cardiotoxicity is reversible in some patients, aggressive supportive therapy is warranted.
Why is doxorubicin cardiotoxic?
Anthracycline-induced cardiotoxicity is due in large part to the generation of free radicals from doxorubicin through mitochondrial redox cycling of doxorubicin in the cardiomyocyte, which ultimately results in left ventricular dysfunction, and in the most severe cases, congestive heart failure.
How do you reduce cardiotoxicity of doxorubicin?
Use of PEGylated liposomal doxorubicin has been shown to decrease the cardiotoxicity of this anthracycline, even at doses >500 mg/m2 [64, 65]. The antioxidant, probucol, has been shown to prevent the decrease in LVEF in animal models of doxorubicin cardiotoxicity [66, 67].
How is doxorubicin used to diagnose heart failure?
The measurements of neurohormones and cardiac enzymes have been used for the diagnosis of doxorubicin cardiotoxicity and presence of heart failure. Plasma levels of B-type natriuretic peptide are elevated and correlate with the severity of congestive heart failure [42].
What are the risk factors for doxorubicin cardiomyopathy?
Cancer therapy in childhood and adolescence predisposes to the development of doxorubicin cardiomyopathy in adults [8]. Age also influences the risk of developing doxorubicin cardiomyopathy. Very young and very old individuals are more prone to develop this complication.
What is the incidence of doxorubicin in the US?
The incidence is about 4% when the dose of doxorubicin is 500–550 mg/m2, 18% when the dose is 551–600 mg/m2and 36% when the dose exceeds 600 mg/m2[7]. The other risk factors are combination therapy with other cardiotoxic antitumor drugs and mediastinal radiation therapy.
What are the contraindications for the use of fundfolfirinox?
FOLFIRINOX is contraindicated for use in pregnancy. Adequate contraception must be used by both sexes during treatment and for at least 6 months after the last cycle. Breastfeeding is contraindicated. Routine toxicity rating of diarrhea and other GI effects, fatigue, cholinergic symptoms, hypersensitivity, pneumonitis, bleeding]