Abstract 448P
Background
Cardiotoxicity represents an unexpected and potentially life-threatening toxicity in colorectal (CRC) patients (pts) treated with fluoropyrimidines (FP). Currently, there are no predictive factors of FP-induced cardiotoxicity (FIC), moreover the correlation between FIC and known cardiovascular (CV) risk factors remains controversial.
Methods
CRC FP naïve pts have been enrolled at Candiolo Cancer Institute from January 2016 to February 2020. Before the start of FP-based chemotherapy (CT), all patients were screened for CV comorbidities and potential risk factors with an optimization of the cardiological treatment if needed. During the first 3 CT cycles, pts were monitored with CV symptoms collection, serial electrocardiograms and brain natriuretic peptide (BNP) measurement, as well plasma samples were obtained. Primary objective was the incidence rate of FIC. Secondary objectives comprised the study of risk factors for FIC including BNP baseline levels and the validation of circulating microRNAs (c-miRNAs) as potential biomarkers of FIC.
Results
A total of 135 pts (60.7% men, median age 66 years) were included in the interim analysis, of whom 48.7% presented CV risk factors. During the treatment period 20 pts (15%) experienced FIC: 1 acute coronary syndrome, 1 coronary vasospasm, 1 paroxysmal supraventricular tachycardia, 1 complete left bundle branch block, 3 syncope, 4 typical chest pain, 6 sudden dyspnea and 3 sudden palpitations. A higher incidence of FIC in women (p. 0.048) was highlighted. No correlation between age ( 75 years), cardiovascular risk (high/low), type of FP (5-fluorouracil/capecitabine) and disease status (adjuvant/metastatic) was observed. Among symptomatic pts 10 (50%) had CV comorbidities and/or CV risk factors. A decreasing trend in BNP values was observed in pts treated with capecitabine who experienced FIC, but this result did not reach statistical significance yet.
Conclusions
Although FIC was observed in a not negligible percentage of patients, no relationship with CV comorbidities or risk factors was found. A more precise correlation of cardiac events with c-miRNAs will be available at completed recruitment (200 pts).
Clinical trial identification
NCT02665312.
Editorial acknowledgement
Legal entity responsible for the study
Candiolo Cancer Institute FPO-IRCCS.
Funding
Candiolo Cancer Institute FPO-IRCCS.
Disclosure
All authors have declared no conflicts of interest.