P-0255 - Cardiac toxicity with fluoropyrimidines in colorectal cancer

Date 28 June 2014
Event World GI 2014
Session Poster Session
Topics Anti-Cancer Agents & Biologic Therapy
Complications of Treatment
Colon Cancer
Rectal Cancer
Presenter Esther Una Cidon
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors E. Una Cidon1, P. Alonso2, T. Hickish3
  • 1Oncology Department, Royal Bournemouth Hospital, NHS Foundation Trust, Bournemouth/UK
  • 2Clinical University Hospital, Valladolid/ES
  • 3Oncology Department, Royal Bournemouth Hospital NHS Foundation Trust, Bournemouth/UK



Fluoropyrimidines are the backbone of the majority of approved chemotherapy regimens for colorectal cancer. Though generally well tolerated, however, they are not free of toxicities including cardiopathies.


We carried out a retrospective review to evaluate cardiac toxicity in those patients receiving a fluoropyrimidine, either capecitabine or 5-fluorouracil for colorectal cancer. Patients who had received a fluoropyrimidine in the past 2 years were evaluated and those who had a cardiac toxicity were included in our analysis.


We evaluated 756 patients, 76% had colon cancer and 24% rectal cancer. 16.8% had a cardiotoxicity. Most of them (56%) had chest pain with ischaemic changes in the ECG (angina and myocardial infarction), tachyarrhythmia with palpitations (26%), symptomatic bradyarrhythmia (13%), hypotension (5%). 3 patients died of cardiac arrest after a heart attack. Most of these patients were having capecitabine (78%) and the rest were having 5-fluorouracil in a continuous infusion. 92% of those patients developing ischaemic changes had a pre-existing ischaemic condition. We have not evaluated subclinical changes in the ECG while having these treatments.


Larger studies are necessary to evaluate cardiac toxicity with fluoropyrimidines to know risk factors predisposing to this toxicity and to prompt a correct treatment. We plan to carry out a prospective study to evaluate subclinical ECG changes with fluoropyrimidines.