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Bradycardia induced by irinotecan: a case report
T Miya1, R Fujikawa, J Fukushima
1Department of Surgery II, Kyorin University School of Medicine, Mitaka, Tokyo, Japan. toshimichi@mtg.biglobe.ne.jp
Japanese Journal of Clinical Oncology
|December 23, 1998
Summary
Irinotecan chloride (CPT-11), a chemotherapy drug, can cause bradycardia (slow heart rate), a rare cardiovascular side effect. This finding highlights the need for careful monitoring beyond typical toxicities like diarrhea.
Area of Science:
- Oncology
- Pharmacology
Background:
- Irinotecan chloride (CPT-11) is a semi-synthetic camptothecin analogue with antitumor activity.
- Diarrhea is the primary toxicity, while cardiovascular events are rare, with only minor arrhythmias noted in Japanese trials.
Observation:
- A 69-year-old man with recurrent colon cancer developed bradycardia during CPT-11 infusion.
- Other toxicities, including hematological effects and diarrhea, were mild.
- Pharmacokinetic analysis showed no correlation between bradycardia and excessive drug exposure.
Findings:
- Bradycardia can be a clinically significant cardiovascular toxicity of CPT-11.
- This adverse event may be underreported due to its subtlety or lack of thorough investigation.
Implications:
- Clinicians should monitor for cholinergic effects, including bradycardia, in patients receiving CPT-11.
- Comprehensive patient monitoring is essential for the safe administration of CPT-11, extending beyond common toxicities.