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Chemotherapy-induced cardiomyopathy caused by Pemetrexed
Takuya Oyakawa1, Kei Iida2, Masatoshi Kusuhara3
1Division of Cardiology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan. t.oyakawa@scchr.jp.
Investigational New Drugs
|June 30, 2017
Summary
This case report details a patient with lung cancer who developed severe cardiomyopathy from pemetrexed chemotherapy. Early detection and drug cessation improved her cardiac function, highlighting critical treatment strategies.
Area of Science:
- Oncology
- Cardiology
- Pharmacology
Background:
- Chemotherapy-induced cardiac toxicity is a serious concern in cancer patients.
- Pemetrexed is an anticancer drug, and serious cardiac toxicity has not been previously reported.
Observation:
- A 59-year-old woman with stage IV lung adenocarcinoma developed shortness of breath during pemetrexed maintenance therapy.
- Cardiac imaging revealed severe left ventricular dysfunction (ejection fraction 28%) and expansion.
- Myocardial biopsy excluded other causes of cardiomyopathy, such as inflammation or fibrosis.
Findings:
- The patient was diagnosed with pemetrexed-induced cardiomyopathy.
- Discontinuation of pemetrexed and initiation of heart failure treatment (diuretics, ACE inhibitors, beta-blockers) led to symptom and functional improvement.
- This case highlights a previously unreported serious cardiac adverse event associated with pemetrexed.
Implications:
- Early recognition and cessation of the causative agent are crucial for managing chemotherapy-induced cardiotoxicity.
- Prompt treatment with standard heart failure therapies can reverse cardiac dysfunction.
- Oncologists and cardiologists should be vigilant for cardiac complications during pemetrexed treatment.
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