Frickhofen N, Beck F J, Jung B, Fuhr H G, Andrasch H, Sigmund M
Department of Hematology/Oncology, HSK, Dr-Horst-Schmidt-Kliniken GmbH, Wiesbaden, Germany.
Ann Oncol. 2002 May;13(5):797-801. doi: 10.1093/annonc/mdf035.
Capecitabine is a member of a new class of oral fluoropyrimidines. It is a 5-fluorouracil (5-FU) prodrug, activated by a series of enzymes. Activation has been demonstrated to occur preferentially in tumor tissue, which may explain the favorable balance of efficacy and toxicity of this drug. Cardiotoxicity, a rare but potentially serious adverse effect of 5-FU, has not been reported for capecitabine to date. Here we report a patient who experienced a severe and prolonged acute coronary syndrome during treatment with capecitabine. He had previously developed similar symptoms during treatment with infusional 5-FU. Capecitabine should thus be considered an agent with cardiotoxic potential. This adverse effect should be specifically monitored in all patients treated with capecitabine. Patients with symptoms suggestive of cardiotoxicity during previous treatment with a fluoropyrimidine should not be treated with capecitabine.
卡培他滨是新型口服氟嘧啶类药物的一种。它是一种5-氟尿嘧啶（5-FU）前体药物，通过一系列酶激活。已证实激活优先发生在肿瘤组织中，这可能解释了该药物疗效和毒性的良好平衡。心脏毒性是5-FU一种罕见但潜在严重的不良反应，迄今为止卡培他滨尚未有相关报道。在此我们报告1例在接受卡培他滨治疗期间发生严重且持续时间长的急性冠状动脉综合征的患者。他之前在接受静脉输注5-FU治疗期间也曾出现类似症状。因此，应将卡培他滨视为具有心脏毒性潜力的药物。对于所有接受卡培他滨治疗的患者均应特别监测这种不良反应。既往接受氟嘧啶治疗期间有提示心脏毒性症状的患者不应使用卡培他滨治疗。
