5-FU Cardiotoxicity: Vasospasm, Myocarditis, and Sudden Death

Area of Science:

• Cardiology
• Oncology
• Pharmacology

Background:

• 5-fluorouracil (5-FU) is a widely used chemotherapy agent.
• 5-FU is a common cause of chemotherapy-induced cardiotoxicity.
• Clinical guidelines for diagnosing and managing 5-FU cardiotoxicity are lacking.

Purpose of the Study:

• To summarize mechanistic and clinical data on 5-FU cardiotoxicity.
• To guide clinicians in the diagnosis and management of patients with suspected 5-FU cardiotoxicity.

Main Methods:

• Review of existing mechanistic and clinical data.
• Synthesis of information to inform clinical practice.

Main Results:

• 5-FU cardiotoxicity presents with diverse manifestations.
• Resuming 5-FU treatment after cardiotoxicity is challenging.
• Genetic variant testing may aid in risk assessment.
• Uridine triacetate is an approved antidote for severe cases.

Conclusions:

• 5-FU cardiotoxicity is poorly understood with limited data.
• Individualized risk-benefit assessment is crucial for treatment decisions.
• Management strategies require further research and prospective trials.