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5-Fluorouracil cardiotoxicity induced by alpha-fluoro-beta-alanine
Katsuki Muneoka1, Yoshio Shirai, Naoyuki Yokoyama
1Department of Surgery, Niitsu Medical Center Hospital, Niigata, Japan.
International Journal of Clinical Oncology
|December 22, 2005
Summary
A rare complication of 5-fluorouracil (5-FU) chemotherapy, cardiotoxicity, was observed in a patient with high alpha-fluoro-beta-alanine (FBAL) levels. Switching to S-1, a 5-FU derivative, resolved cardiotoxicity and showed treatment efficacy.
Area of Science:
- Oncology
- Cardiology
- Pharmacology
Background:
- 5-fluorouracil (5-FU) is a common chemotherapy agent for various cancers.
- Cardiotoxicity is a rare but serious adverse effect of 5-FU treatment.
- The exact mechanism of 5-FU-induced cardiotoxicity is not fully understood.
Observation:
- A 70-year-old man with metastatic colon cancer developed precordial pain and right bundle branch block during 5-FU infusion.
- This cardiotoxicity coincided with a significantly elevated serum level of alpha-fluoro-beta-alanine (FBAL), a 5-FU metabolite.
- Symptoms resolved upon 5-FU discontinuation, and FBAL levels decreased.
Findings:
- The patient was subsequently treated with S-1, an oral 5-FU derivative that inhibits FBAL production.
- Serum FBAL levels decreased substantially after initiating S-1, and no cardiac events recurred.
- The patient achieved a partial response to S-1 therapy, indicating its efficacy.
Implications:
- This case suggests a strong association between high serum FBAL levels and 5-FU-induced cardiotoxicity.
- S-1 may be a safer alternative for patients who experience cardiotoxicity with 5-FU.
- Monitoring FBAL levels could potentially aid in managing 5-FU cardiotoxicity.
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